Delayed presentation of a mitral annular perforation complicating Staphylococcus aureus infective endocarditis

This report describes a patient who presented with congestive heart failure secondary to a mitral annular-left atrial fistula. There was a remote history of Staphylococcus aureus endocarditis involving the mitral valve which was treated medically 30 years previously. The sterile fistula was managed surgically with an annuloplasty.