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A 30-year old woman presented with neurological symptoms and a patent foramen ovale (PFO) that was closed with a Nit-Occlud® PFO. At the 6-month follow-up, the device was found in the aortic arch (Fig. 1A and B) and all efforts to retrieve it percutaneously were unsuccessful. Surgical intervention was indicated, the PFO directly closed (Fig. 1C) and the device removed under hypothermic circulatory arrest (Fig. 1D–F). Conflict of interest: none declared.

Late surgical retrieval of a nitinol occluder system embolized in the aortic arch: Figure 1: