A 64-year-old woman with a history of mechanical aortic valve repair was referred for surgical evaluation. The patient presented with fever, weight loss, and shortness of breath. Preoperative assessment revealed a positive blood culture with Escherichia coli and complete atrioventricular block. A left heart catheterization evidenced normal-functioning coronary arteries and a dehiscent mobile prosthetic aortic valve (AV). Preoperative transesophageal echocardiography showed multiple mobile echo-densities attached to the AV prosthesis, a large echo-lucent space around the aortic root, thickening of the intervalvular fibrous body (IVF), and a moderate +2 mitral valve regurgitation.