Case Report: Endothelialized but unstable: late migration of a ventricular septal defect closure device

Late device migration following transcatheter perimembranous ventricular septal defect (VSD) closure is exceedingly uncommon, as most cases of embolization occur within the first hours to weeks after implantation. In the present case, migration was observed 18 months post-procedure, representing an unusually late presentation. Notably, surgical retrieval demonstrated complete circumferential endothelialization of the device, confirming true long-term tissue incorporation before subsequent erosion and detachment. Furthermore, serial early and mid-term imaging consistently showed a stable device position, making early malposition or technical error an unlikely cause. This constellation of findings underscores the rarity of very late mechanical destabilization after an initially successful device closure.