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Patent Foramen Ovale (PFO) Closure

A foramen ovale is a hole between the two atrial chambers of the heart. It normally closes after birth. When it doesn't, it is called patent foramen ovale (PFO).

Generally, a patent foramen ovale doesn't cause complications. But some studies have found the disorder is more common in people with certain conditions, such as unexplained strokes and migraines with aura. In rare cases a patent foramen ovale can cause blood to bypass the lungs, resulting in low blood oxygen.

If there are symptoms, PFO closure is a procedure that may be done to close the hole. Using cardiac catheterization, doctors can insert a disk that plugs the PFO. This disk becomes a permanent implant.

Why choose Presbyterian for your patent foramen ovale (PFO) closure?

Presbyterian Heart and Vascular Care has a team of highly-skilled surgeons who are using some of the most advanced techniques to perform this procedure. These techniques can improve recovery time, reduce complications and provide a quicker return to work and other daily activities.

Who is eligible for a patent foramen ovale (PFO) closure?

A PFO may need to be closed if it is linked to low blood oxygen levels or a stroke, and no other treatment has worked. A PFO is usually found with an echocardiogram.

What conditions can be treated with a patent foramen ovale (PFO) closure?

A PFO may be closed to:

  • Treat low blood oxygen levels linked to the PFO.

  • Reduce the risk of recurrent strokes when no other cause can be found.

  • Reduce the risk of an enlarged heart. If the PFO is large, large amounts of blood can move back and forth between the left and right sides of your heart. This can create pressure and cause your heart to enlarge.

How do I prepare for a patent foramen ovale (PFO) closure?

To prepare for a PFO closure:

  • Consume clear liquids until you leave for the hospital, but no dairy products and no solid foods after midnight the night before.

  • Make arrangements for someone to drive you home the next day.

What should I expect during my patent foramen ovale (PFO) closure?

PFO closure is done with cardiac catheterization. Cardiac catheterization is a procedure in which a catheter (a long, thin, flexible, hollow tube) is inserted into a large vein, usually in the inner thigh (groin area), and threaded through the vein to reach the heart.

An imaging test called an angiogram (injection of a certain type of dye followed by an X-ray motion picture) may be used to get a better view of the heart. An ultrasound imaging technique known as an intracardiac echocardiogram (ICE) will also be used to see the defect better and determine the size of the closure device needed.

The ultrasound imaging device is also advanced up to the heart through the vein. In addition, a special balloon on a catheter may be moved to the area of the hole and inflated to measure the size of the hole, so the correct device size is chosen. The ICE displays the heart structures and blood flow as the hole is gently stretched by the balloon and as the device is positioned to close it.

The device will remain in the heart permanently to stop the abnormal flow of blood between the two atrial chambers of the heart. The catheter is then removed, and the procedure is complete. The procedure takes one to two hours to complete. Over time, heart tissue grows over the device, further strengthening the closure.

How do I care for myself after my patent foramen ovale closure (PFO)?

  • Aspirin or other blood-thinning drugs will need to be taken every day for six months or longer to prevent blood clots from forming.

  • You'll need to take antibiotics before certain medical procedures (for example, dental procedures and certain surgeries) for up to six months after the device is placed.

  • As with all medications, take them as directed by your doctor. Call your doctor if you have any unpleasant reactions or have any concerns.

  • Follow-up return trips to the hospital will be necessary to monitor the patient's heart and device placement over the next year. Each visit will include a chest X-ray, electrocardiogram, and echocardiogram.