The incidence of nosocomial infective endocarditis (IE) has increased in the last 2 years during the COVID-19 pandemic and the patients might present with overlapping symptoms of heart failure and pneumonia. Simultaneously, COVID-19 is a hypercoagulable disorder that can complicate the postoperative course of a patient undergoing valve replacement. Therefore, the exact pathology of the native valve needs to be evaluated in such patients. We describe a case of a 45-year-old man with a history of non-compressive myelopathy and COVID-19 infection scheduled for aortic valve replacement and subaortic membrane resection. Intraoperative transesophageal echocardiography was instrumental in defining the aortic valve anatomy that changed the management plan.
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