Transcatheter closure of patent foramen ovale after left ventricular assist device implantation: intraoperative decision making.

The presence of a patent foramen ovale in patients with heart failure can be missed during echocardiography despite the use of provocative maneuvers. Implantation of a left ventricular assist device in these patients can result in right-to-left shunting and hypoxemia. We report the use of a percutaneous atrial septal defect closure device as an alternative to surgical closure.