Objective To assess the factors influencing the early and mid-term survival of patients receiving a second replacement of the left atrioventricular valve, so as to provide guidance for clinical practice. Methods We retrospectively analyzed 55 patients who underwent a second replacement of the left atrioventricular valve between Jan. 2005 and Dec. 2010 at Changhai Hospital. Their survival rate and its risk factors were analyzed. The control group included patients who received their first left atrioventricular valve replacement at the same hospital and had matched age, sex, and operation time. Univariate and multivariate Cox survival analyses were used to assess the survival risk factors at 30 days and 3 years after operation. Results The 30-day, 1-year, 3-year and 5-year survival rates of patients after reoperation were 92.7%,89.1%,83.6%,and 81.8%, respectively, which were not significantly different from those of the control group(94.5%, 92.7%, 90.9%, and 87.3%, respectively). The left ventricular ejection fraction was the only independent predictor of 30-day survival of patients after reoperation(P=0.018,RR=15.33). Diabetes mellitus and left ventricular ejection fraction were the independent predictors of 3-year survival (P=0.039,RR=6.242 and P=0.001,RR=91.957, respectively). ConclusionThe early and mid-term mortality rates are not significantly different between the first and second replacement of left atrioventricular valve. Left ventricular ejection fraction is the only independent predictor of early-term survival after re-replacement of left atrioventricular valve; diabetes mellitus and left ventricular ejection fraction are the independent predictors of mid-term survival.