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Late Recurrent Left Atrial Mass in Patient With Patent Foramen Ovale Occluder Device
Xuan Zhou1, Christophe Hansen-Estruch2, Daniela de Lima Corvino3
1Department of Internal Medicine, University of Alabama at Birmingham Montgomery Campus, Montgomery, Alabama, USA.
JACC. Case Reports
|April 18, 2025
Summary
Device-related thrombosis after patent foramen ovale (PFO) closure is rare, especially over a decade post-implantation. This case highlights a very late, recurrent thrombus, emphasizing the need for long-term patient vigilance.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Neurology
Background:
- Patent foramen ovale (PFO) closure is a common treatment for recurrent cryptogenic stroke.
- Complications typically occur early after device implantation.
- Very late device-related thrombosis is a rare but challenging complication.
Observation:
- A patient presented with thromboembolic stroke 15 years after PFO device placement.
- A left atrial mass attached to the PFO occluder was identified.
- Infectious workup was negative, despite pathology suggesting an infectious origin.
Findings:
- The patient experienced early recurrence of thrombus after surgical excision.
- Reoperation and device extraction were necessary.
- This represents an exceptionally uncommon case of very late, recurrent device-related thrombus.
Implications:
- Highlights the need for long-term vigilance in patients with PFO occluders.
- Underscores diagnostic and management challenges of rare, late-onset complications.
- Suggests potential for late-onset, recurrent thrombus formation even without typical risk factors.
