Patent foramen ovale (PFO) is a common congenital heart defect associated with cryptogenic stroke and migraines. Although percutaneous PFO closure is generally safe and effective, rare complications may necessitate surgical device explantation. This chapter presents a case of a 54-year-old woman with increased migraine frequency, chest pain, and atrial fibrillation following PFO closure with an Amplatzer device. Nine years later, she suffered an embolic stroke despite no residual shunt or thrombus. Robotic-assisted surgical explantation revealed severe fibrosis on the device. Post explantation, her symptoms resolved. The case highlights the potential for delayed complications from PFO closure, including suspected nitinol intolerance, even with negative allergy testing. Although explantation is rare, its severity warrants attention. Device type, patient-specific risk factors, and long-term monitoring may influence outcomes. Ongoing research is needed to identify patients at risk for adverse reactions and improve patient selection and device biocompatibility.