Concomitant Gerbode-like defect and anterior mitral leaflet perforation after aortic valve replacement for endocarditis.

We present a case of concomitant left ventricle (LV) to right atrial shunt (Gerbode-like defect) and anterior mitral leaflet perforation in a 32-year-old male after aortic valve replacement for infective endocarditis of bicuspid aortic valve. This case emphasises that intra-operative transesophageal echocardiography is a sine qua non for valvular surgical procedures.