Bizarre case of migration of a retained epicardial pacing wire

A 71-year-old woman, who had undergone mitral valve replacement procedure 2 years previously, presented with aortic and mitral prosthetic valve endocarditis. Preoperative examination demonstrated a wire-like structure coursing from the aortic bulb to the right carotid artery. The wire-like structure was removed during the mitral and aortic valve reoperation, and identified as an epicardial pacing wire, which was placed during the patients' first mitral valve operation. We suspect that the contaminated pacing wire migrated via the left atrium and left ventricle into the right carotid artery causing an infective endocarditis of the prosthetic mitral valve and the native aortic valve.