Prosthetic valve endocarditis is a formidable complication following cardiac valve replacement. Surgical intervention has resulted in a significant reduction in mortality when certain complications prevail. We report two such cases of prosthetic valve endocarditis in which the use of transesophageal echocardiography permitted close surveillance during medical therapy and thus avoided the need for surgical intervention. Therefore, with the improved ability to monitor disease progression with transesophageal echocardiography, nonsurgical management of prosthetic valve endocarditis remains an option
