RESUMO
We report a 64-year-old woman with fungal prosthetic valve endocarditis. She underwent the aortic valve replacement (SJM 19 A<sup>®</sup>) with annular enlargement using autologous pericardium. She had a persistent fever and congestive heart failure 8 months after surgery. Echocardiogram demonstrated vegetations of the aortic prosthetic valve, perivalvular leakage and third degree mitral valve regurgitation. Double valve replacement was performed concomitant with aortic annular enlargement using a xenograft. The aortic valve prosthesis was found to be detached from the aortic annulus on the side of the left coronary sinus and also from the implanted autologous pericardium. There were vegetations on the aortic prosthesis and the autologous pericardium. Histopathological findings led to the diagnosis of fungal endocarditis of the aortic prosthetic valve and antifungal therapy was started on the second postoperative day. She is in good condition 5 years later without any relapse of inflammation and has been receiving antifungal treatment. The surgical method of aortoatrioplasty with double valve replacement was effective for fungal prosthetic valve endocarditis after aortic valve replacement with annular enlargement.