There have been several reports of right-to-left shunting through patent foramen ovale (PFO) after implantation of a left ventricular assist device (LVAD). The atrial pressure changes after assist implantation leading to revelation of undetected PFOs may cause severe systemic hypoxemia. A percutaneous closure approach has been shown to be an adequate therapy option in patients with LVAD. We report a successful interventional occlusion of a PFO with right-to-left shunt in a patient with biventricular HeartWare® ventricular assist device (HVAD) support.