Mycotic aortic aneurysms comprise <5% of all aortic aneurysms, but have a high risk of rupture if not treated urgently. Concomitant valvular infective endocarditis poses additional therapeutic challenges in relation to staged repair. Current surgical recommendations for mycotic aortic aneurysms involve urgent repair, due to the high risk of rupture and associated mortality. The presence of infective endocarditis necessitates early valve replacement to avoid further systemic emboli or seeding of vascular grafts; however, the risk of heparin loading during cardiopulmonary bypass on a friable aorta poses significant risks.