Late recognition of Gore Helex atrial septal occluder fracture and migration

Patent foramen ovale (PFO) closure is indicated in cryptogenic stroke. Percutaneous PFO closure is both feasible and highly efficacious with low incidence of device-related complications. When complications occur, they are usually discovered within 6 weeks of device deployment. We describe the case of a partially embolised and fractured Gore Helex Septal Occluder device recognised nearly 9 years after placement requiring surgical explant. <Learning objective: Device-related complications with patent foramen ovale closure devices are exceeding rare. Our case highlights the need for continued long-term device monitoring with periodic imaging given the ongoing risk for device-related complications.>.