Interatrial septal closure devices and aortic perforation: a note of caution.

Percutaneous defect closure is well established in patients with a symptomatic patent foramen ovale (PFO). Despite a safe interventional procedure, severe complications have been described during device implantation or follow up. Two patients are described whose cases may serve to warn of an unusual complication associated with a closure device. Several weeks after percutaneous PFO closure, perforation of a device strut into the aortic root was evident in both asymptomatic patients. The perforations were repaired surgically and both patients had further uneventful follow-ups. Procedures which could decrease the risk of device perforation should be adhered to and the indication for closure should consider this potential complication.