Systemic Embolism in Mitral Stenosis: Relation to the Size of the Left Atrial Appendix

Abstract

Systemic embolism in patients with mitral stenosis was more than 3 times commoner when the left atrial appendix was large than when small. Conversely, the left atrial appendix was larger in patients with a history of embolism than in those without it. The occurrence of embolism rose steeply in successive decades when the appendix was large but not when it was small. A number of patients presenting with systemic embolism and only slight rheumatic mitral-valve involvement have disproportionate enlargement of the left atrial appendix. Amputation of the appendix and relief of mitral stenosis, however slight, is recommended here as a protection against further emboli.