Infective endocarditis is least likely to occur in

Ref Harrison 19 th ed pg 816 Infection most commonly involves hea valves but may also occur on the low-pressure side of a ventricular septal defect, on mural endocardium damaged by aberrant jets of blood or foreign bodies, or on intracardiac devices themselves. The analogous process involving aeriovenous shunts, aerio-aerial shunts (patent ductus aeriosus), or a coarctation of the aoa is called infective endaeritis.