Effects of anticoagulation on recurrent systemic emboli in mitral stenosis

Systemic arterial embolization can be expected in at least 20% of patients with mitral stenosis (MS) and recurrence without treatment may be expected in as many as 60% of these patients. 1 Embolization may occur as the first manifestation of MS, and may occur in patients without significant cardiac functional impairment. 1,2 In patients with significant cardiac functional impairment, the treatment to prevent recurrence of embolization is clearly surgical; however, when there is little or no cardiac functional impairment, treatment is controversial. Surgical therapy is recommended by some, while long-term anticoagulant therapy without surgery is the choice of others. 1,3