Patent Foramen Ovale or Atrial Septal Defect Closure

There are two kinds of holes in the heart:

• In fetal circulation, the foramen ovale is an opening that allows blood to bypass the lungs of a fetus and go directly from the right upper chamber of the heart to the left. Shortly after birth the foramen ovale closes permanently in most people. A patent foramen ovale (PFO) occurs when the flap-like opening does not close after birth. This hole allows blood to pass from the right upper chamber to the left upper chamber, which is not normal. Many times, a PFO is not discovered until adulthood. Sometimes the first sign of a PFO is a stroke or transient ischemic attack (TIA).
• An atrial septal defect (ASD) is a hole in the wall of the top two chambers of the heart. An ASD is a failure of the septal tissue (found between the two upper chambers of the heart) to form, while in utero. This is considered a congenital heart defect. An ASD can be small or large. The larger the ASD, the more blood allowed to leak from one upper chamber to the other, causing strain on the heart.

To diagnose a PFO or an ASD, a physician may order an echocardiogram to see the structure and function of the heart. A CT scan or cardiovascular MRI may also be used to help make the diagnosis.

When treatment is needed for either a PFO or ASD, a team of heart specialists will help determine the proper course of treatment:

• Open Heart Surgery to close the PFO or ASD.
• Percutaneous Septal Closure is a minimally invasive procedure. This less invasive approach requires the use of a catheter (a thin, flexible tube) with a PFO closure device on the end. The catheter is guided into a vein (in the groin) and then to the heart where the closure device is used to plug the PFO or ASD.