Fracture of a GORE HELEX Septal Occluder following PFO closure in a diver

Abstract

Decompression illness (DCI) is more common in divers with a patent foramen ovale (PFO), and transcatheter PFO closure is being increasingly performed in patients with an episode of DCI who want to continue diving. A range of closure devices are available and the choice in an individual case depends on operator preference and PFO anatomy. The GORE HELEX Septal Occluder, introduced in 1999 primarily for secundum atrial defect closure, is a compliant non self-centering device composed of a wire helical framework on which a microporous membrane is mounted. The device is fixed in place by a unique interlocking mechanism that passes through the center of the device from the left to the right atrial disc, thereby securing it onto the interatrial septum. Here, we present a case of a locking loop fracture and review the literature concerning this unusual complication.