Understanding Patent Foramen Ovale (PFO)

A Patent Foramen Ovale (PFO) occurs at birth and is known as a hole in the heart. In fetal circulation, the foramen ovale is an opening that allows blood to bypass the lungs and go directly from the right atria to the left atria. Shortly after birth, the higher pressure in the left atria and the lower pressure in the right atria causes permanent closure of the foramen ovale in the majority of people. In approximately 25% of people, the foramen ovale fails to close and could lead to a cryptogenic stroke.

 

Can a PFO closure reduce your risk of having a stroke?

Many times a PFO is not discovered until adulthood. If a doctor found a PFO it is important to speak with your healthcare professional to see if closing the hole in your heart can help reduce the risk of stroke.

 

I have had an unidentified stroke

If you had a stroke and no identifiable cause of the stroke could be found, your doctors may conclude that you have a PFO. If this has occurred, your PFO would have caused a blood clot to pass from the right side of your heart to the left side of your heart, blocking a blood vessel that supplies the brain and caused a stroke.

 

 

Treatment options

 

Catheter-based procedure to close the PFO

  • The procedure takes approximately one to two hours
  • A local anesthetic is used at the site where the closure device is introduced to the body (usually a vein in the right groin area), along with general anesthesia or conscious sedation
  • Hospitalisation is six to 24 hours

Medical Management

  • Your doctor may prescribe blood-thinning medication to reduce the chance that clots form in your blood

Surgical closure of the PFO

  • Surgical repair involves directly suturing a patch over the PFO. Surgical PFO closure is rarely performed today following a cryptogenic stroke

 

The PFO closure procedure – What to expect

 

 

After PFO closure – What to expect

 

Complications

What are the potential risks of the procedure?

As with any medical procedure, there is a possibility of complications due to the device and/or the procedure. Potential risks include, but are not limited to:

Most common

  • A noticed or unnoticed rapid or irregular heartbeat
  • Headache or migraine
  • Dizziness or abnormal sensation
  • Chest pain or discomfort
  • Upper respiratory infection
  • Back pain • Nausea
  • High or low blood pressure
  • Pain at the incision site
  • Difficulty breathing
  • Bleeding
  • Fatigue
  • Anxiety
  •  

Most serious

  • Death
  • Stroke (major or minor)
  • Heart attack
  • Kidney failure
  • Clot formation or blood vessel blockage due to clots or air
  • Injury to the heart or blood vessels
  • Perforation of the heart muscle or blood vessels
  • Blood or fluid build-up between the heart and the sac covering the heart
  • Infection

Other

  • Movement of the device from its position in the PFO to other parts of the body
  • A second surgical or interventional procedure
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