Some recently developed problems in cardiac surgery for acquired heart diseases, in our department, have been discussed in this paper. Ischemic heart disease (IHD): Indication for aortocoronary bypass grafting (ACBG) has been extended for the patients with poor left ventricular function. The number of the patients, who are found to have IHD before general surgery have been increased. Surgical treatments for these patients, five with malignant tumor, and two with aneurysm of the descending aorta, were performed 16 days to 4 months after ACBG without any operative death. In three patients with lesions of carotid arteries, blood flow of the carotid arteries was monitored with doppler echography, which was found useful for this purpose, during extracorporeal circulation. One hundred and four patients, over 40 years old, for valvular surgery, had coronary angiography at the cardiac catheterization between 1982-1983. Nine patients (8%) had significant IHD. They had ACBG and valvular surgery simultaneously. Valvular heart disease (VHD): Long-term results following aortic valve replacement have showed that 6 deaths were of cardiac origin. Five of them were with poor preoperative left ventricular function (ejection fraction: 0.35 or less, left ventricular endsystolic volume index: 200 ml/m2 or more) which might be indices for indication of surgical treatment for aortic regurgitation.