Ubi pus, ibi evacua (where there is pus, there evacuate it) is a Latin aphorism attributed to the Greek Galen of Pergamon and considered to be the only remedy for infections in the second century AD. The introduction of antibiotics has radically changed the treatment of infections, but surgery still plays an important role in the management of infective endocarditis (IE), particularly in the context of congenital heart disease (CHD). In this edition of the IJC Moore et al. [1], and other contemporary reports, suggest that the incidence of IE amongst adults with CHD remains substantial, between 0.91 and 1.32 cases/1000 patient-years, as opposed to the non-CHD population (5–7/100,000 patient-year) [3].