A 61-year-old male presented to emergency department with symptoms of shortness of breath, palpitations, and night sweats. We performed bedside transthoracic echocardiography which showed shunt from the left ventricle to the right atrium in systole with color Doppler examination. Gerbode-type ventricular septal defect and an image of a fibrillar, mobile mass compatible with vegetation was observed just above the tricuspid valve. We performed transesophageal echocardiography which showed vegetations on the aortic valve noncoronary cusp. Two sets of blood cultures were positive for Streptococcus sanguinis. The patient was evaluated by the heart team and an operation decision was made for the patient. The patient underwent surgery after 2 weeks of antibiotic theraphy. In the surgery, the Gerbode-type ventricular septal defect was closed with a polytetrafluoroethylene patch. Tricuspid annuloplasty was performed with De Vega technique. Mechanical aortic valve was implanted. Postoperative transthoracic echocardiography showed no residual shunt.