Patent Foramen Ovale (PFO) Closure

Innovative Approach to Patent Foramen Ovale Repair

Interventional cardiologists at Beth Israel Deaconess Medical Center (BIDMC) provide the latest treatments for closing a hole in the heart. Our minimally invasive procedure provides treatment for people with a patent foramen ovale (PFO) who had a previous stroke.

What is a PFO?

Under normal conditions, blood returns from your body to the heart through the right upper chamber (an atrium). Then the heart pumps the blood through the lungs to receive oxygen. Freshly oxygenated blood then returns to the heart’s left atrium for the heart to pump to the rest of the body. A thin wall called a septum separates the two atria. The septum prevents blood flow between the atria. 

The foramen ovale is small hole in the septal wall that enables blood circulation in utero and naturally closes after birth for most people. For roughly one in four individuals, the foramen ovale remains open into adulthood. 

Known as a patent foramen ovale, or PFO, this condition doesn’t have a negative effect on most people’s health. However, in some cases, a blood clot can move through the PFO from the right side of the heart and eventually reach the brain, causing a stroke. 

PFO Diagnosis

Your doctor may use a type of ultrasound called a transthoracic echocardiogram (TTE) to diagnose this condition. TTE creates an image that shows the heart's internal parts. 

Only people who have larger PFOs and have previously had a stroke need a PFO closure procedure. A cardiologist and neurologist work together to determine if each person needs their PFO closed.

What is a PFO Closure?

If you need your patent foramen ovale (PFO) closed, we use a minimally invasive catheter procedure. We perform this procedure in a cardiac catheterization room. PFO closure typically takes one to two hours. You'll likely receive local anesthesia in the groin where the catheters enter the skin, as well as intravenous (IV) sedation so you sleep through the procedure.

Your doctor makes an incision (cut) in your groin and inserts the catheter (long, thin, flexible tube). We guide a small device through the catheter and to the location of the patent foramen ovale. We position the device on each side of the septal wall, where it will permanently remain to stop the abnormal flow of blood between the heart's two atrial chambers.

During this procedure, your care team uses ultrasound imaging to guide the procedure and determine the size of device that you need.

After the procedure, you'll need to lay flat for four hours.