Retrieval of Embolized Amplatzer Patent Foramen Ovale Occlusion Device: Issues Related to Late Recognition

Abstract

Embolization of a percutaneous patent foramen ovale (PFO) closure device is a rare but serious complication. While early, periprocedural device embolization can normally be managed with snare and percutaneous retrieval, late embolization requires a different management strategy due to inability of the device to deform to allow passage into a large caliber sheath. We present a case of asymptomatic device embolization recognized six months following implantation and discuss the challenges encountered in successfully retrieving the device.

When a patent foramen ovale device is no more in place: silent patent foramen ovale occluder device migration to the aortic arch

“…A successfully placed PFO closure device straddles the thick muscular septum secundum with its two disks and is subsequently covered up and stabilized by endothelial tissue, so the long-term dislodgement is uncommon 2 . Given the inability of these devices to retract and compress, as they would when initially implanted, 3 to allow the passage into a vascular sheath, often an open-heart surgical approach is recommended.…”