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Valvular endocarditis caused by Aspergillus is a lethal disease. Only two survivors, both with infections of prosthetic valves, have been reported in the world literature. This report describes a patient with an Aspergillus valvular endocarditis on a native valve with embolization to the right axillary, left iliac, and left popliteal arteries and the distal aorta. Diagnosis was made from a thromboembolectomy specimen. Treatment consisted of removal of the peripheral arterial emboli, mitral valve replacement, and prolonged intravenous infusion of high-dose amphotericin B. The patient presently has the longest survival period of any patient with an Aspergillus infection on a native heart valve. The importance of early diagnosis and aggressive operative management by the vas~lar surgeon needed to properly treat these patients is emphasized. (J VASe SURe 1986; 4: 187-91.) Acute arterial insufficiency is commonly duc to emboli, but only rarely is it a mycotic embolus. Vo, Russell, and Becker ~ reviewed 44 cases of mycotic

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