Aortic valve endocarditis with perivalvular abscess formation remains a demanding condition and the results of the surgery are not optimal. Abscess localized in the aortic basis area can weaken the aortic wall, leading to further deterioration and rupture. The presented case allows us to recommend a maximal aggressive approach in patients, in whom the aortic wall seems to be rearranged due to abscess formation. Sometimes only the resection of the abscess hole and replacement of the entire ascending aorta offers a safe therapy option.