Mitral Valve Infective Endocarditis Complicated by Vegetation Migration to the Common Femoral Artery Bifurcation

Infective endocarditis is rare but carries significant morbidity, including risk of systemic embolization. A 67-year-old woman presented with endocarditis. Evaluation revealed a mobile mitral valve vegetation and a right atrial mass. Owing to prohibitive surgical risk, percutaneous aspiration thrombectomy was pursued. Immediate preprocedural transesophageal echocardiography revealed that the mitral mass had embolized in the interval, and it was incidentally found in the common left femoral artery on ultrasound. The patient underwent aspiration thrombectomy of the right atrial mass and open surgical extraction of the mitral valve vegetation from the femoral artery in the same index procedure. This case highlights the high embolization potential of these types of valvular vegetations and the need for rapid intervention.