Introduction: Invasive aspergillosis is a life-threatening complication in immunocompromised patients with mortality rates between 30 and 90 percent. Due to the sub-optimal outcome of the standard approach with antifungal monotherapy (either azoles or echinocandins) combined antifungal therapy has become a point of interest. Results of in vitro studies, animal models and case reports suggest that antifungal combination therapy with azoles (e.g. voriconazole, posaconazole, ravuconazole) and echinocandins (e.g., caspofungin, micafungin, anidulafungin) may have additive activity against aspergillus species. We present three cases of invasive pulmonary aspergillosis in heart transplant recipients that were successfully treated with a combination of voriconazole and micafungin.