RESECTION OF THE LEFT AURICULAR APPENDIX

A therapeutic problem which remains unsolved is the one pertaining to recurrent arterial emboli. Once a peripheral embolus has occurred there is a high incidence of recurrence. Unfortunately, all too frequently the recurrent embolus is fatal, commonly involving one of the cerebral arteries.¹As Jefferson so aptly stated²: "In the nature of things a very high percentage of successes is unlikely ever to be attained, for emboli are apt to be multiple and further infarction will sometimes carry off the patient in whom a local success has been won." Since a thrombus is the precursor of every arterial embolus, the ideal prophylaxis for recurrent arterial emboli should be the removal of the thrombus together with its site of origin. Rheumatic mitral stenosis is one of the commonest causes of a peripheral arterial embolus, an embolus occurring in approximately 45 per cent of the cases.^1bIn this disease the