Aim: We aimed to answer the question of: are patients over 75 years of age associated with poor survival in combined operations? and to identify independent risk factors that predict survival in patients undergoing these procedures. Methods: Data were collected prospectively from 476 patients who underwent combined procedures at Kings College Hospital between 1998 and 2004. Patients were divided into two groups, group A: 341 patients under the age of 75 years and group B: 136 above age of 75 years. In-hospital mortality was used for survival analysis. Statistical analysis was performed using Stata 6. Results: Median age was 71 years (range 26–88). Three hundred and twenty six (68%) patients were male. In addition to the coronary grafting, 339 (71%) patients had operation on aortic valve, 132 (27.7%) on the mitral valve, 5 (1%) on both valves and 1 (0.2%) on the tricuspid valve. The following were identified as an independent predictors of in-hospital mortality; female sex (OR 3.193, CI 1.118–8.589, P =0.022), and emergency surgery (R 346.5, CI 27.282–4400.793, P = 0.043).