We are very thankful to Dr. Vendramin et al. (1) for their interest in our article about the “off label” use of new cardiac prosthetic valves in different clinical scenarios, and for their thoughtful comments.

We describe the case of a 59-year old female affected by aortic extensive endocarditis with communication between aortic annulus and right cavities, treated with double pericardial patch reconstruction and rapid-deployment aortic valve prosthesis implantation.