about 70 y old patient with intermitted fever, high inflammatory markers in blood, prolonged weakness and a new diastolic murmur of heart in Erb-position. In clinical history there was an implantation of aortic bio-prosthesis about 6 month ago. In TTE we could find a very high transprosthetic gradient and an aortic insufficiency. In TEE you can see a typical endocarditic vegetation of aortic valve prosthesis. In this case we decided to send that patient to cardiac surgery, because of that large vegetation. Do you agree? Or do you prefer a conservative/ nonsurgical therapy?