The analysis of a series of 839 cases of mitral valve disease has shown the following. ( a) Systemic embolism is as common with mitral regurgitation as with mitral stenosis. (b) Atrialfibrillation, with clot formation in the atrium, is the main cause predisposing to systemic embolism. ( c) Mitral valve calcification is important only in that it predisposes to operative emboli. ( d) Atrial appendage size has no influence on the occurrence of systemic embolism, and atrial appendagectomy has no influence on the occurrence of post-operative embolism. ( e) Only in patients with atrial fibrillation and an operable valve, is there any reduction in the number of emboli after surgery.
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Coulshed et al. (1970) studied this question.