Abstract
We report a rare case of late cardiac perforation after percutaneous closure of patent foramen ovale with the Cardia Star device (Cardia, Gent, Belgium), which presented as acute pericardial tamponade and was initially misdiagnosed as acute type A aortic dissection. The clinical course was dramatic in our patient and might have resulted in sudden death without prompt surgical treatment. The clinicians involved in treating a patient with acute, unexplained cardiac tamponade should be aware of late cardiac perforation occurring after percutaneous patent foramen ovale closure.