Introduction 
The incidence of infective endocarditis (IE) has increased over the last decades. Between January 2016 and March 2018, the European Infective Endocarditis Registry (Euro-Endo)2 recorded 3,116 adult patients with IE according to diagnostic criteria in 2015 of theEuropean Society of Cardiology (ESC)3.
IE was most frequent on native valves (56.6%), followed by prosthetic valves (30.1%) and, finally, on intracardiac devices (9.9%). The majority of cases were community-acquired IE (65.66%) and the most frequently isolated microorganism was Staphylococcus sp (44.1%), followed by Enterococcus sp (15.8%) and Streptococcus sp(12.3%). The main complications were embolisms in 20.6% of the patients, which usually associated with right and aortic valve IE, even more frequently if caused by Staphylococcus aureus or vegetations existed.
Regarding location, left IE was more common than right IE. The aortic valve was the most frequently affected valve (49.5%), then the mitral valve (42%) and the tricuspid valve (11.4%), being the pulmonary valve (PV) the least frequent with only 2.4% of the cases3,5.
Most often, pulmonary valve infective endocarditis (PVIE) occurs in active injecting-drug abusers or whenever chronic vascular accesses or pacemakers are present5. Other predisposing risk factors for native valve IE are immunosuppression, diabetes mellitus, cancer, kidney dialysis and HIV. The incidence for native PVIE is reckoned to be solely around 0.2 to 1.2%1.
An explanation of the clinical presentation, echocardiograms, the surgical procedure and postoperative care of an adult patient with native PVIE and no significant medical history nor risk factors is included.