There is Nothing More Invisible than the Obvious: A Case Summary and Literature Review.

Bioprosthetic valvular failure (BVF) is a pathological entity arising from a variety of conditions affecting prosthetic heart valves. It may present with an extremely varied pattern, and the identification of the exact etiology is vital to provide a prompt and adequate treatment. It is established that infective endocarditis mainly affects patients with intracardiac devices such as pacemakers or prosthetic valves, and it represents one of the principal mechanisms of BVF. Despite its high incidence, clinical presentations may be atypical, and a close monitoring is essential to prevent catastrophic consequences. We present the case of a partial valvular bioprosthesis detachment associated with a newly formed pseudoaneurysm due to a late infective endocarditis occurred after cardiac surgery, initially manifested with negative blood cultures and clinical findings. We also try to set up a literature review of the most common causes of valvular failure and pseudoaneurysm formation.