A patent foramen ovale (PFO) is a hole or tunnel in the wall of the septum between the top chambers of the heart (right and left atria). PFOs only occurs after birth when the foramen ovale fails to close.
For most people with a PFO, it is not a problem, even though blood can leak from the right atrium to the left. Problems can arise when that blood contains a blood clot.
About 25% of the general population has a patent foramen ovale. Most people with a patent foramen ovale don’t even know they have it. For the majority of people, it may not cause any symptoms.
How is an PFO diagnosed?
An ultrasound of the heart called a 2 D echo is the best way to view the PFO. An ultrasound probe called a Transoesophageal is used during the procedure so that the cardiologist can see the defect better and also helps to determine the size of the closure device required.
A PFO is closed using during a procedure called cardiac catheterisation. The PFO closure device is threaded through the catheter to the specific location of the heart wall defect. Once the device is in the correct position, it is allowed to expand its shape to cover each side of the hole. This device remains in the heart permanently to stop the abnormal flow of blood between the two atria of the heart. The catheter is removed once the procedure is completed.
The cardiac catheterisation procedure for a PFO closure typically takes about 1 – 1.5 hours to complete. For this procedure, a general anaesthesia is used. There will be an anaesthetist and anaesthetic nurse monitoring you throughout the procedure.
You will need to take things easy over the next couple of days. There will be a small dressing over the site, and it is important to keep it clean and dry. The nurse on the ward will put a new dressing over the area on the day of discharge. There may be a small bruise, and the site may even be tender over the next couple of days. An ice pack may be useful, and your doctor may prescribe a mild pain killer.
You will need to take aspirin for six months after the procedure. Aspirin will help to prevent small blood clots from forming around the device. You will be given a prescription for aspirin before you are discharged home from the hospital.
You may need to take antibiotics before and after dental treatments for six months after the procedure. These drugs help prevent a heart infection called infectious endocarditis.
Your will receive an appointment for follow-up about 6 months after the procedure.