The results of surgical treatment of paraannulary abscess secondary to infective endocarditis are frequently disappointing and these conditions necessitate more complicated surgical interventions because of excessive destruction of fibrous skeleton of the heart.

A 27 years old male patient who had fever and dispnea, suffering from itravenous substance addiction for a long time was admitted to our hospital. During fist week of antibiotic therapy that was accepted as being aortic valve endocartitis after investigations rupture of noncoronary sinus of Valsalva to the right atrium was diagnosed. The patient was undertaken to the operation in emergency conditions because of impending cardiogenic shock.

The aortic wall, annulus and subannulary reigon to noncoronary cusp was excessively destructed. After excision of the aortic valve and excessive debridement, annular and subannular reconstruction was performed with autologous pericardium and supported by teflon strip, then 21mm Medtronic-Hall mechanic prothesis was implanted to the annular position.

In conclusion, surgical intervention should be performed as early as possible in case endocarditis associated with paraannulary abscess which is able to lead mortal complications.