Patent Foramen Ovale

PFO can be diagnosed through an echocardiogram (ultrasound imaging test of the heart). Sometimes, a “bubble test” may be required during an echocardiogram to confirm the presence of a PFO.

There is usually no follow-up or treatment required if the patient does not suffer from any symptoms. In certain circumstances, however, the doctor may recommend a procedure to close the PFO.

PFO Closure Procedure

PFO closure is a minimally invasive, catheter-based procedure that involves the use of a device called the "occluder”, to close the PFO.

Studies have shown that patients with stroke (aged between 18 and 60 years old) who are treated with PFO closure, have lower risk of recurrent stroke. Possible procedure related complications, however, may include:

Serious risks (less than 1%)

• Death
• Stroke
• Fluid build up in heart muscle and sac of the heart
• Blood clot in the heart, legs or lung
• Irregular and or rapid heart rate
• Perforation of heart muscle or vessel
  
  

Other potential risks (less than 10%)

• Blood vessel blockage due to blood clot or air
• Allergic reaction
• Infection
• Bleeding
• Injury to nerves in arm or lower neck
• Pacemaker implant
• Device migration
  

However, not all PFOs need to be closed. The PFO device was approved in 2016 by the US Food and Drug Administration (FDA) based on 10 year resuts of a randomized study which involved patients <60 years old with PFO and cryptogenic stroke (of unknown cause). It compared patients treated with PFO device plus blood thinning medications with patients treated with blood thinning medications alone and found a 50 percent reduction in new strokes in patients with PFO device.

Other less common indications for closure include decompression illness in professional divers, cyanosis (mixing of deoxygenated [blue] blood in the left chambers causing breathlessness especially with certain posture.