In order to analyze results of the first reoperations for structural degeneration of bioprostheses, a series of 524 consecutive patients reoperated on between 1978 and 1998 was reviewed retrospectively. In the original procedure, 648 bioprostheses were implanted in the mitral (n = 403), aortic (n = 220) and tricuspid (n = 25) positions. The mean interval between the original procedure and reoperation was 8.8 ± 3.3 years. The in-hospital mortality rate was 8% for the entire series, but only 3.9% and 4% for elective mitral and aortic single reoperative valve replacement. In-hospital mortality for single and multiple reoperative valve replacement was 6% and 12.4%, respectively (p = 0.02). Other multivariable predictors were: old age, NYHA functional class, presence of ascites, and reoperation performed before 1988. In-hospital mortality at reoperation for degeneration of bioprostheses is acceptable for single reoperative valve replacement as opposed to multiple reoperative valve replacement.