title: Late migration of percutaneous bio-absorbable devices--a word of caution.
abstract: BACKGROUND
  Closures of atrial septal defects or a patent foramen ovale (PFO) are increasingly performed percutaneously. The experience of late migration of a new bio-absorbable device is presented here, followed by conceptual discussion.
  
  
  METHODS
  Six months post PFO closure with a BioSTAR® device a patient presented with chest pain. Echocardiography showed a hyperechogenic structure perforating the aortic wall.
  
  
  RESULTS
  Surgical exploration showed a perforation of the ascending aorta by one metallic, non absorbable arm. This is the second case of late (>6 months) dislocation of the residual framework of the occluder.
  
  
  CONCLUSIONS
  The overall incidence of perforation of cardiac structures due to secondary dislocation is low. However this complication exists and should kept in mind in symptomatic patients with new onset of chest pain, after percutaneous procedures. The concept of biodegradation, with residual, non absorbable metal braiding, should be reviewed, analyzing in particular long term results and incidence of secondary dislocation.
authors.affiliation: Department of Cardiovascular Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. giulia_vottero@yahoo.it
authors.forename: Giulia V
authors.initials: GV
authors.lastname: Vottero
authors.forename: Lars
authors.initials: L
authors.lastname: Niclauss
authors.forename: Carlos
authors.initials: C
authors.lastname: Marcucci
authors.forename: Michel
authors.initials: M
authors.lastname: Hurni
authors.forename: Ludwig K
authors.initials: LK
authors.lastname: von Segesser
mesh_terms: D020341:Absorbable Implants; D000328:Adult; D001011:Aorta / Q000293:injuries* / Q000601:surgery; D004868:Equipment Failure; D054092:Foramen Ovale, Patent / Q000601:surgery*; D005548:Foreign-Body Migration / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D008297:Male