Day 1	Patient admitted for a month-long fever, weight loss, mild cough, and dyspnoea; auscultatory findings confirmed the presence of a continuous murmur.
Day 2	Patient found to be septic, blood cultures positive for a multi-sensitive Streptococcus mitis strain, antibiotic therapy with ceftriaxone started.
Day 3	A chest computed tomography scan highlighted multiple pseudo-nodular cavitations, bilateral pneumonia, hilar adenopathy, and pronounced right atrial profile.
Day 4	Transoesophageal echocardiography colour Doppler showed right atrial dilation and bacterial vegetations inside a tunnel-like structure originating from the right coronary sinus and connected to the right atrium.
Day 30	Patient was treated for a total of 28 days with ceftriaxone with normalization of inflammatory markers and a consensual lung lesions improvement.
Two months after discharge	Patient transferred to University hospital. Three-dimensional multidetector computed tomography angiography confirmed the presence of an aorta-right atrial tunnel (ARAT) and better defined its anatomy. After heart team discussion, catheter-based closure was decided.
Three months after procedure	Transoesophageal echocardiography colour Doppler showed correct device position with mild left-to-right shunt.
Six months after the procedure	Three-dimensional multidetector computed tomography angiography with volume rendering three-dimensional reconstruction showed correct position of the occlusion device and curved multiplanar reconstructions demonstrated the almost complete occlusion of the ARAT.