What is a Patent Foramen Ovale?

A patent foramen ovale (PFO) is an opening between the left and right atriums of the heart.  In most cases, this hole is sealed at birth by a natural pressure.  For years, physicians regarded this type of opening, which affects about 25 to 35 percent of the U.S. population as inconsequential. Now, new research indicates that PFO's are associated with early stroke in about 50 to 60 percent of the adult population diagnosed with this anomaly. In fact, it is likely that most patients who present with stroke before age 50 have a PFO.

PFOs are diagnosed through a non-invasive technique known as Transesophegeal Echocardiography (TEE). Using ultra-sound technology and a transducer, physicians can get very clear pictures of the heart and study its structures carefully.

Until recently, the unfortunate reality was that once the PFO had been identified, there were few options available  to  patients.   These  options  included  a  surgical  procedure  to  close  the  hole  or    a  lifetime  of anti-coagulant therapy to minimize the possibility of clots in the bloodstream.

But in May of 2000, the U.S. Food and Drug Administration (FDA) approved using an umbrella-like device to seal the opening between the two atriums. This treatment actually repairs the patient's opening, without the complications and risks associated with surgery.   After the PFO is repaired, the risk of strokes or recurring strokes drops dramatically.

Repairing a PFO  

PFOs can be closed in a minimally invasive manner in a one-hour procedure.   A catheter is inserted into the femoral artery by way of the groin area. The umbrella is attached to the end of the catheter and is guided through the heart and positioned into the opening.  At this time, the front of the umbrella is released.  As the catheter is retracted, the back of the umbrella releases, sealing the opening. The catheter is removed and within four to six months, heart tissue will grow around the device.  

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