Embolization of cotton pledgets following insertion of porcine cardiac valve bioprostheses.

A variety of complications involving heart valve implants have been documented. Embolism originating from thrombosis of the valve has been a recurrent problem in mechanical and to a lesser extent porcine implants. We report two accidental deaths as a result of embolization of cotton pledgets from porcine valves. Hospital personnel failed to remove this cotton material from the valves before surgical placement. In the first case, when portions of the pledgets embolized to both carotid arteries, fatal cerebral infarction occurred. In the second case, portions of the pledgets embolized to a coronary artery producing severe left ventricular failure.