[Infectious endocarditis with aortic annular abscess detected by intraoperative transesophageal echocardiography]

We experienced a case of an endocarditis with persistent fever despite appropriate antibiotic therapy. Intraoperative transesophageal echocardiography showed bicuspid aortic valve with vegetations which caused a severe aortic regurgitation. Furthermore, a new abscess formation extending to the aortic annulus was detected by transesophageal echocardiography. A stentless valve was used to reconstruct the aortic valve with a subcoronary method. Patients with bicuspid valve infectious endocarditis incur high risk of abscess formation. It is important to have frequent observation of the infected valve preoperatively and careful observation during operation to detect further abnormalities which may cause alteration of the procedure.