Background: Left ventricle (LV)-right atrium (RA) communication is a rare lesion and its etiology is almost exclusively congenital. Rarely, LV-RA communication could be seen due to infective endocarditis (IE).Case Report: Herein, we reported a 12-year-old boy with acquired LV-RA communication secondary to IE. This case was under consideration for aortic regurgitation (AR), aortic stenosis (AS), active IE with multiple vegetations on the aortic valve and complicated with immune complex glomerulonephritis. During hospitalization, the patient suddenly developed severe congestive heart failure. The patient underwent an emergency operation resulting in detection of a LV-RA communication, which was closed with a dacron patch and aortic valve replacement (AVR) was performed. on the 9th postoperative day, the patent died because of an acute cerebral hemorrhage.Conclusions: In selected cases, who have developed sudden congestive heart failure and in the occurrence of new murmurs or increases in the intensity of existing ones, LV-RA communication must be remembered and urgent surgical intervention must be considered.

Keywords: infective endocarditis, acquired left ventricle-right atrium communication, renal failure, open-heart surgery