A 55-year-old man who had severe aortic regurgitation by bacterial endocarditis associated with severe alcoholic liver cirrhosis admitted in our hospital for the treatment of congestive heart failure. ICG15' score was 45.0% and redox tolerance test score was 0.38 x 10(-2). Preoperative hepatic function state was estimated as Child B. Preoperative preparation for the liver cirrhosis was done with FFP and glucagon insulin treatment. Aortic valve replacement was performed under the pulsatile high flow and high perfusion pressure during cardiopulmonary bypass. Post operative course was fair and he discharged.