“… 4 , 8 The distal location of an embolus and patient symptoms, including signs of malperfusion, should be used as clinical guides to determine the urgency of retrieval. In this case, Helgeland 1 wisely chose to first address the patient's hemodynamic compromise with redo-mitral valve replacement before performing further diagnostic studies, followed by retrieval of the embolized piece during a second operation.…”