To evaluate the perioperative left ventricular function in 36 patients undergoing aortic valve replacement (AVR) in patients with isolated chronic aortic regurgitation (AR), hemodynamic variables before and within the first 24 hours and one month after operation were measured with Swan-Ganz catheter and echocardiography. The patients were divided into two groups based on preoperative left ventricular end-systolic volume index (LVESVI): 5 patients had a LVESVI of 90 ml/m2 and greater (group I), 31 had a LVESVI smaller than 90 ml/m2 (group II). Left ventricular dimension at end-diastole and end-systole, left ventricular end-diastolic volume index at one month after operation significantly decreased in comparison with that of preoperation. However, left ventricular ejection fraction in the two groups were not improved, and left ventricular mass index in group I did not decreased. On the other hand, changes of cardiac index, stroke volume index and left ventricular stroke work index within the first 24 hours after operation were not significantly different between the two groups. The incidence of postoperative premature ventricular contraction in group I was significantly higher than that of group II. However, there was no difficult problems in postoperative management of the two groups. It is suggested that AVR in AR with left ventricular dysfunction can safely be operated and its postoperative management is similar to AVR in AR with no left ventricular dysfunction.