Medically Reviewed by Brian D. Blaker, MD

Before we’re born, there’s a small hole inside the upper chambers of the heart that helps a baby develop in the womb. In some people, that hole doesn’t heal after birth. McLeod Cardiologist Dr. Brian Blaker explains a simple procedure to repair the Patent Foramen Ovale (PFO).

Here is a summary of Dr. Blaker’s comments:
I think it’s important for people not to be afraid if they are diagnosed with a Patent Foramen Ovale (PFO). One out of four people have it. So, 25% of the population will have one and, in most people, it’s of little consequence.

A PFO is a small connection between the left and right atrium in the top chambers of the heart. Most people will have it when they are born. It allows for adequate blood flow to the baby while they are the mother’s womb. After most people are born, that connection closes. In about one out of four patients however, that connection can remain open.

In a small percentage of patients – such as those who suffer uncontrolled migraine headaches or a stroke where you can’t find another cause — there’s some evidence that a PFO could be a contributing factor. In those patients, there is an opportunity to close the PFO using a device that inserts in the hole and prevents blood from flowing between the two chambers.

Traditionally, PFO’s were closed with full open heart surgery – many times during the course of surgery for another cause, such as a valve disease or coronary artery disease. More recently there’s been the development of catheter-based techniques. A PFO is often discovered when a patient has an ultrasound of the heart for another purpose. If somebody isn’t having symptoms or haven’t had a prior stroke, the PFO is usually of no consequence.

If a person needs the procedure, we bring them into our cardiac catheterization lab and use moderate sedation. We use some local anesthesia in the groin and insert a small catheter into the vein. We then put a wire from the right side into the left side of the heart and advance a small device called an “occluder” device across the wall that divides the right and left atrium (the upper chambers of the heart). We then deploy it, opening much like an umbrella. The device seals the opening, blocking blood flow back and forth between the two chambers.

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