Closure of Patent Foramen Ovale (PFO)
Updated: Oct 13, 2020
A Patent Foramen Ovale (PFO) is a hole in the heart that didn't close as it should have after birth. During development of the foetus, a small flap/opening is present in the heart wall between the right and left atria (upper chambers of the heart). A patent foramen ovale can occur in up to 25% of the population and many people will never know they have it and therefore never need treatment for is.
It is still unclear exactly what causes a patent foramen ovale although it is thought that genetics might play a role.
Usually when a baby is in the womb, because they aren't breathing the lungs do not need blood pumped to them. Therefore, the umbilical cord delivers oxygenated blood to the right atrium, most of this travels through the foramen ovale and into the left atrium. From here the blood travels to the left ventricle to go to the rest of the body.
In a newborn baby, as the lungs begin to work, the circulation of blood through the heart changes to the normal route that we know (see blog post on the heart). The pressure of the blood travelling through the heart is usually enough to push the flap shut and it then fuses naturally during the first few weeks/months of life. However, this doesn't always happen.
Patients with an unclosed or Patent Foramen Ovale don't usually have complications, however is has been shown that there maybe a link with strokes and migraines with aura (although studies are still ongoing).
Many patients with a PFO will never need treatment however in some circumstances your doctor may suggest a PFO closure.
Closure of Patent Foramen Ovale (PFO) is a catheter based procedure which means that a catheter (a long, thin, flexible tube) is inserted from a vein in the groin area and advanced to the heart via the veins. The PFO closure device is also advanced to the heart via the catheter.
The procedure is performed with imaging to help place the patent foramen ovale closure device and measure the correct size of device needed. Once the correct size and position are confirmed the PFO closure device breaches the gap in the heart and stops the abnormal flow of blood between the atria. Then the catheter is removed.