Key result
Late left atrial mass after PFO closure shows benign tissue from atypical endothelialization rather than thrombus.
Why the study?
Late masses on patent foramen ovale occluder devices may mimic thrombus or vegetation, requiring differentiation for appropriate management.
Case Report (n=1)
Late masses on patent foramen ovale occluder devices can mimic thrombi or vegetations but may represent atypical endothelialization, necessitating multimodality imaging and pathological confirmation.
Late LA masses post-PFO closure may represent atypical endothelialization; this Level 5 case extends the differential and leaves optimal management open.
IMAGE(S): Transesophageal echocardiography, cardiac computed tomography, and histopathology. CASE SUMMARY: A 50-year-old man with previous cryptogenic stroke and patent foramen ovale closure was found to have a large mobile mass on the left atrial side of the occluder approximately 33 months after implantation. Surgical extraction was performed because of embolic risk. Pathology demonstrated benign myocardium mixed with adipose tissue, supporting atypical endothelialization rather than thrombus or infection. TAKE-HOME MESSAGES: Late masses on patent foramen ovale occluder devices may mimic thrombus or vegetation. Multimodality imaging, surgical inspection, and pathology are essential for diagnosis.
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Shah et al. (2026) conducted a case report in Patent foramen ovale closure complicated by late left atrial mass (n=1). Surgical extraction of left atrial mass was evaluated on Pathological diagnosis of the extracted mass. Surgical extraction and pathology of a late left atrial mass post-PFO closure demonstrated benign myocardium mixed with adipose tissue, indicating atypical endothelialization rather than thrombus.
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