Early-to-mid onset bacterial endocarditis following implantation of Gore Cardioform Septal Occluder device

Area of Science:

• Cardiology
• Infectious Diseases
• Medical Device Technology

Background:

• Patent Foramen Ovale (PFO) closure is a common procedure to prevent paradoxical embolism.
• Septal occluder devices, such as the Gore Cardioform Septal Occluder, are frequently used for PFO closure.
• Infection of implanted cardiac devices is a rare but serious complication.

Observation:

• A 37-year-old female developed bacterial endocarditis associated with a 30 mm Gore Cardioform Septal Occluder.
• The device was implanted to treat multiple paradoxical strokes secondary to a PFO.
• The patient required surgical explantation of the infected device and pericardial patch repair.

Findings:

• Endocarditis following PFO closure device implantation is exceedingly rare.
• Most cases of device-related endocarditis occur in the early postoperative period.
• Incomplete endothelialization of the device within the first 3 months post-implantation poses the highest risk, though late-onset cases are also reported.

Implications:

• Current recommendations for prophylactic antibiotics after device implantation (first 6 months) may need to be extended.
• Consideration for prolonged prophylactic antibiotic therapy in high-risk patient populations is warranted.
• This case highlights the importance of vigilance for device-related infections even in rare instances.