Patent foramen ovale (PFO): Ready to help manage your stroke risk

While about 95% of people with a PFO will never be affected , a small number of those with this condition absolutely should be treated to lower their risk for future strokes.

Every baby has a PFO while they are still in their mother’s uterus. In about 75% of births, the PFO closes on its own as soon as the baby starts breathing on its own. Most of the remaining 25% whose PFO stays open will never have a problem. Unfortunately, for a few of these people, having a PFO may allow small blood clots to pass through the heart and up to the brain where it can cause a stroke or transient ischemic attack (TIA), which is like a stroke but does not leave lasting brain damage.

People who are potential candidates for PFO closure are usually referred from a neurologist to a cardiologist following an unexplained stroke or high-risk transient ischemic attack (TIA). Several clinical studies have demonstrated that for appropriate patients, having a PFO closure significantly reduces the risk for future strokes when compared with taking stroke-prevention medication alone.

PFO closure is a minimally-invasive outpatient procedure that is performed in the catheterization laboratory by an interventional cardiologist who uses specialized devices approved by the U.S. Food & Drug Administration (FDA). You are given a mild sedation before the procedure.

The interventional cardiologist inserts a catheter, or thin tube, into your femoral artery, which is a blood vessel near the groin. Once the catheter reaches your heart, the doctor carefully closes the PFO by placing a circular mesh-and-wire seal (similar to a stent) on one side of the hole and another seal on the other. Your heart tissue will grow around and eventually cover the seals.

Most patients go home the same day, although a few will spend one night in the hospital. Patients are advised to take it easy for a few days. Virtually all patients recover fully within a week.