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Objective To evaluate the early outcomes ofmitrial valve replacement with GK mechanical prosthesis.Methods From Jan.2007 to Jun.2013, 684 patients have undergone isolated mitral valve replacement with a GK mechanical prosthesis.The mean patient age was 46.70± 13.54 years and the mean course of disease was13.17±8.29 years.543 of 684 patients were in New York Heart Association (NYHA) functional class Ⅲ or Ⅳ.509 patients were combined with atrial fibrillation.41 patients were re-operation.There were 53 cases suffered from effective endocarditis and 75 cases underwent emergency operation.Results There were 7 early deaths (1.02%).Of 684 patients, 30 suffered from low cardiac output syndromes, 6 multiple organ failure, 11 malignant ventricular arrhythmia, 12 respiratory failure and 6 kidney failure.677 patients were discharged from hospital and all of them were undergone follow-up from 6 months to 3 years.All survivors were in NYHA functional class Ⅰ or Ⅱ at their last follow-up.The mean trans-valvular gradient of mitrial valve is less than 9 mmHg during follow-up.1 patients suffered from anticoagulant thrombus both at mitrial and tricuspid valve 1 month after discharge and recovered after re-operation.1 patient suffered from peri-valvular leakage 4 months later, and recovered after re-operation too.Conclusion The GK mechanical prosthesis implantation is safe and effective for mitrial disease.