Recurrent Infective Endocarditis Involving Bicuspid Aortic Valve Presenting with a Rare Complication: The Deadly Kiss

Bicuspid aortic valve, the most common congenital cardiac lesion, is frequently associated with infective endocarditis (IE), and this combination is notoriously associated with increased prevalence of periannular complications. Mitral valve involvement as a “kissing” lesion secondary to aortic valve endocarditis is a very rare entity. Only few case reports are available describing this lesion. We report a case of recurrent IE involving both cusps of bicuspid aortic valve complicated by “kissing” lesion of the anterior mitral leaflet leading to aneurysm formation. The patient presented with severe aortic regurgitation and moderate mitral regurgitation. The patient was treated successfully with surgical aortic valve reconstruction (Ozaki procedure) with mitral valve repair.