We present the challenging case of a young man with congenital heart disease who survived severe device-related infective endocarditis and new pulmonary hypertension. He required prolonged mechanical circulatory support and had multiple significant complications. His case posed a management dilemma that was successfully resolved by effective multidisciplinary, tertiary center care.JACC Editor-in-ChiefJulia Grapsa, MD, PhD, FACCCME EditorNadeen N. Faza, MD, FACCAuthorsNada Al-Sakini, MBChB, PhDWasyla Ibrahim, MBChB, BS (Hons)Important DatesDate of Release: August 4, 2021Term of Approval/Date of CME/MOC/ECME Expiration: August 3, 2022