Late thrombus formation on the Helex septal occluder after double-lung transplant

Percutaneous device closure in patients with an atrial septal defect (ASD) or patent foramen ovale (PFO) has gained popularity because of the short learning curve, cosmetic advantage and relative safety compared with surgery. Device complications may include device embolism, erosion, pericardial tamponade or thrombus formation, and most complications occur early. Herein we describe the previously unreported finding of a late thrombus on a Helex device after PFO closure in a patient with cystic fibrosis and double-lung transplantation.