Infective endocarditis (IE) represents an important challenge at many levels. This is becoming all the more pressing with the opioid epidemic, which was declared a public health emergency in 2017. The study by Yang and colleagues¹ specifically addresses the impact of aortic root abscesses in a cohort of 336 consecutive adults undergoing surgery for IE. The authors' main conclusion was that despite the added complexity and risk of perioperative complications in patients with aortic root abscesses, operative outcomes were favorable. The authors should be congratulated for their excellent results in a challenging patient population. Their results raise several important points.