rheumatic heart disease, occurring in approximately 45 per cent of the cases. In 15 to 20 per cent of the cases of rheumatic heart disease, a cerebral embolus is the immediate cause of death. The differentiation between an autochthonous thrombus and an arterial embolus may be impossible even at operation or necropsy.Two cases are reported in which a resection of the left auricular appendix was done as a prophylaxis for recurrent arterial emboli. The first patient survived, and the second died.Resection of the left auricular appendix is suggested as a prophylaxis for recurrent arterial emboli. The one indication for the operation is in a patient with rheumatic heart disease and mitral stenosis, with or without auricular fibrillation, who has had one or more recent peripheral arterial embolie occlusions.

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