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What Is a PFO in the Heart?

A patent foramen ovale (PFO) is a hole in the heart that doesn’t close as expected after birth. Before a baby is born, they have a hole between the left and right sides of their heart. This hole, called a foramen ovale, allows blood to flow from the mother to the left side of the fetus’s heart during development.

This hole is supposed to close soon after a baby is born. In about 25% of people, the foramen ovale never closes, which is known as a PFO.

Patent Foramen Ovale vs. Atrial Septal Defect

Both a PFO and an atrial septal defect (ASD) are holes in the heart that are present at birth. But in an ASD, the wall (septum) that separates the upper right and left heart chambers never develops properly. An ASD is typically a bigger hole than a PFO.

Patent Foramen Ovale Symptoms

PFOs may not cause any symptoms. You may never know you have a PFO unless you are screened for another heart problem or experience a complication of a PFO.

PFO Symptoms in Adults vs. Infants

Neither adults nor infants tend to experience any symptoms of a PFO. The condition usually is diagnosed later in life.

Patent Foramen Ovale & Stroke

A PFO can lead to a stroke. If you develop a blood clot in the right side of your body, the clot can leave your heart through the PFO and travel to your brain, causing a stroke. Many people don’t know they have a PFO unless they experience a stroke.

Find a PFO Specialist

Patent Foramen Ovale Diagnosis

The main test to diagnose a PFO is a transthoracic echocardiogram with a bubble test:

  1. You will lie flat on your back in a dark room.
  2. A technician will give you an injection of a saline solution with a very small amount of air bubbles through a vein in your arm.
  3. The technician will pass a probe (transducer) over your chest. The transducer uses sound waves to get a picture (ultrasound) of your heart.
  4. You may need to cough or bear down to increase the pressure in the right side of your heart.
  5. As the saline solution circulates through your heart, your doctor may be able to see the air bubbles traveling through the PFO.

This test is noninvasive, but it is not a routine screening. You usually have this test only if you experience a stroke but have no obvious stroke risk factors.

Patent Foramen Ovale Treatment

You may not need any treatment for a PFO if you’ve never had a stroke. Many people with PFO heart defects live long lives without ever experiencing cardiovascular problems. Your doctor may recommend a PFO closure if you’ve had a stroke.

PFO Heart Surgery

We use catheter-based techniques to close a PFO, meaning you don’t need open-heart surgery. During a PFO closure, your surgeon will perform the following steps:

  • Insert a needle in your groin (through a vein) or your neck (which is less common).
  • Thread a catheter through the blood vessel into your heart.
  • Insert a closure device through the catheter and place it in the PFO.
  • Position the device so that it attaches to each side of the PFO and closes the hole.

PFO Closure Recovery

You will stay in the clinic for monitoring and observation for about four to five hours after PFO closure. Many patients return home the same day, but you may need to stay overnight if your doctor feels it is necessary.

Most people can resume their usual activities within several days. Your doctor will give you instructions for recovery while the incision in your groin heals. You will need to avoid contact sports and extreme sports or activities, such as bungee jumping, for at least one year.

The PFO closure device stays in your heart long-term. Eventually, your own heart tissue grows around the device. The PFO closure procedure is extremely successful, with success rates of up to 99%.   

Heart Palpitations After PFO Closure

Very rarely, some people experience atrial fibrillation, or periods of irregular heartbeats, after PFO closure. Clinical trials have shown that these heart palpitations usually go away after a short period. Heart flutters after PFO closure only affect about 2% to 3% of patients.

Our cardiologists will monitor your heart before PFO closure to detect whether you have periods of irregular heartbeats. We may recommend blood thinning medications instead of a PFO closure if you have atrial fibrillation.

Why Choose University of Utah Health?

Our PFO Clinic combines the expertise of interventional cardiologists and vascular neurologists who work together to determine whether you need a PFO closure after having a stroke. We follow national guidelines and aim to provide you with the most effective treatment. You will meet with both of these specialists in one convenient visit. We will discuss all treatment options with you and provide evidence-based recommendations.

We perform a high volume of PFO closures, translating to more experienced physicians and better results. Our team has low complication rates and exceptional patient outcomes.

Refer a Patient

Patients need a physician referral to make an appointment with a PFO specialist. Call 801-581-2897 to refer a patient or make an online referral.