Infective endocarditis still has significant morbimortality, despite
diagnostic and therapeutic improvements. We describe a case of a
67-year-old man with recurrent prosthetic aortic valve infective
endocarditis complicated by massive local tissue damage, making valve
replacement unfeasible. Although rarely performed in this setting, heart
transplantation was a needed salvage strategy, highlighting the need to
make bold decisions for complex clinical scenarios.