Patent foramen ovale (PFO) is relatively common, occurring in 25-30% of the population, and mostly asymptomatic. Percutaneous PFO closure can be recommended in patients under 60 years with embolic-appearing ischemic cryptogenic stroke and PFO with right-to-left shunt, with other etiologies of stroke excluded. 

A few devices have been used for PFO closure, including a STARflex device, Amplatzer PFO Occluder, and Gore Helex and Cardioform Septal Occluders. A nickel-titanium alloy (Nitinol) is frequently used in these devices and appears mildly radiopaque on radiograph and hyper-dense on CT.

Based on device appearance and year of implant, this patient most likely has a Gore Septal Occluder. It consists of a double disc shape made of a single piece of nitinol wire covered with e-polytetrafluoroethylene. It is inserted via a catheter and deployed across the septal defect, thus bridging the PFO.

Disclosure:  I, Hilary Bowman, have no actual or potential ethical or financial conflict of interest in relation to this device. This case is not intended to be a personal endorsement or recommendation of this product.

This case was submitted with supervision and input from:

Soni C. Chawla, M.D.
Associate Professor
Department of Radiological Sciences
David Geffen School of Medicine at UCLA
Olive View - UCLA Medical Center