Perforation of mitral valve aneurysm as an uncommon condition of infectious endocarditis

A 65 year old man with a history of mechanical aortic valve replacement acq uired Enterococcus faecalis mediated infective endocarditis about 3 years l ater. Transesophageal echocardiography revealed formation of an aneurysm co nfined to the anterior mitral valve leaflet. The aortic valve revealed no s igns of endocarditis by transesophageal ultrasound. With sudden perforation of the mitral valve aneurysm, subsequent hemodynamic deterioration and pul monary oedema, the patient underwent emergency mitral and aortic valve repl acement. The postoperative course was uneventful.