Infective endocarditis associated with ruptured aneurysm of Valsalva disrupted the vicinity of aortic annulus (Valsalva, valve, left ventricular outflow tract). This condition did not accept insertion of prosthetic valve at normal position. Insertion of St. Jude valve was performed after the reconstruction of outflow tract with a xenopericardial patch. Proportionate sutures for the right cusp part was taken through the infundibular muscle at the right ventricular side, not in the pericardial patch. The bileaflet valve functioned properly in spite of the oblique insertion.
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