Abstract
56-YEAR-OLD MAN was referred with a 2-week history of Staphylococcus aureus septicemia and bacterial endocarditis on the aortic valve. After 2 weeks of therapy with intravenous antibiotics, he was afebrile with a normal white blood cell count. Because of the appearance of vegetations and moderate-to-severe aortic regurgitation on transthoracic echocardiography, and in the presence of deteriorating renal and hemodynamic function, an aortic valve replacement was performed using a mechanical bileaflet prosthesis. Intraoperatively, inspection of the valve showed no active infection and no vegetations. The noncoronary leaflet of the aortic valve had been eroded, however, and had become detached from the valve annulus. Postoperatively the patient made a good recovery, was extubated on day 1, and was transferred to the regular ward. On the 5th postoperative day, the patient developed refractory pulmonary
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