treatment

PFO (Patent Foramen Ovale) closure

In certain patients, stroke may most likely have been caused by a small thrombus (blood clot) moving from the venous circulation through a PFO to the arterial circulation bypassing the lungs and moving to the brain causing a stroke. In appropriate patients, closure of the PFO has been shown to reduce the risk of further stroke.

What is a PFO?

A PFO is a flap like hole between the top two chambers of the heart. As a foetus all humans have a PFO – it is essential for correct foetal blood circulation. In most infants, the PFO closes, but in 25% of humans it remains open and in most cases causes no issue.

If it is so common why does my PFO need closed?

In patients who have had a stroke with a high probability that their PFO was the cause, closure has been shown to reduce the risk of further stroke. Prof. Shand will take you through the decision making process in detail and make an appropriate recommendation based on your clinical history and investigation findings.

Frequently asked questions

The procedure is minimally invasive and usually performed under general anaesthetic or sedation. A plastic tube is inserted into the femoral vein (large vein in the groin) and after carefully crossing into the lefthand side of the heart, the PFO closure device is positioned using Echo and X-ray guidance. Typically it takes 15-30 minutes to perform.

There is a 1% risk of a major complication. Complications include but are not limited to major bleeding, stroke and complications related to anesthesia and transoesophageal echo (a specialised Echo test). Very rarely (1:500-1:1000 cases) the PFO device can embolise (move) from its intended position and require retrieval. This may rarely require surgery to remove the device. Finally in <5% of patients, atrial fibrillation (irregular heart rhythm) can occur in the days and weeks following the procedure. In the majority of cases this settles by 3 months but may in some cases require additional treatment.

Generally speaking PFO closure is performed as a day case procedure. After an Echo, and examination of the access site in the groin, you will be allowed home. We advise you not to drive or play sport for 48 hours. Most patients require 6 months of aspirin and clopidogrel treatment.

Prof. Shand will be review you several weeks after the procedure, answer any questions you may have and if all is well, most patients can be discharged.

PFO (Patent Foramen Ovale) closure

What is a PFO?

If it is so common why does my PFO need closed?

Frequently asked questions

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