In a 47-year-old man a late postoperative chronic infective prosthetic valve endocarditis became evident 8 years after implantation of a Smeloff-Cutter aortic valve prosthesis. Signs and symptoms of valve endocarditis increased rapidly, so that within 12 months a total valve embolization was found intraoperatively. Three years after emergency reoperation and implantation of a Björk-Shiley prosthesis, good clinical and hemodynamic results were established. Thus, even in prosthesis valve endocarditis with severe consecutive hemodynamic impairment, immediate surgical treatment seems to be mandatory and can be performed successfully with good long-term results if the diagnosis is made in time and if effective antimicrobial therapy is begun.