Percutaneous stabilization of a Helex device following locking-loop fracture: a case report

Though present in up to a quarter of adults a patent foramen ovale (PFO) has been implicated in a diverse range of medical conditions including cryptogenic stroke, migraine and decompression illness. A wide range of devices are available, each with different technical advantages that may favor particular anatomic features. We recently encountered a case of late-locking loop fracture following the use of a Helex septal occluder device (W.L. Gore and Associates, Flagstaff, Arizona) to close a PFO in a diver. This resulted in increased device mobility and continued interatrial shunting. Here we describe the successful stabilization of the original device by transcatheter insertion of a second, less compliant device through the residual atrial shunt.