Patent Foramen Ovale (PFO) and Atrial Septal Defects (ASD) are congenital defects of the heart that are an opening between the right and left sides of the heart that allow blood to travel through them. The percutaneous closure of PFO and ASD is performed using a special closure device. The device is folded or attached on to a special catheter, like the catheter used during a catheterization. The catheter is inserted into a vein in the leg and advanced into the heart and through the defect. The device is slowly pushed out of the catheter allowing the device to open up and cover the congenital opening. The closure of a PFO or ASD may be necessary to lower your risk of a stroke or to improve the dynamics of how your heart works to pump blood.
This procedure is performed in a hospital setting and you will spend the night afterwards. You will likely be asked to have lab work drawn prior to this procedure and given specific instructions about your medications to take or not take prior to the procedure. At the hospital, you will be prepared for the procedure and an IV will be started. The procedure takes place in a catheterization laboratory. You will be monitored with a blood pressure cuff and electrodes will be placed on your chest to watch your heart rate and rhythm. You will be given sedation during the procedure. Your physician will numb the groin area where a small catheter will be placed in the blood vessel where the closure device will be introduced and advanced to the heart where the PFO or ASD is located.
The catheter will be removed from the groin area and pressure will be applied for 20 minutes or more. You will lie flat with your leg straight for several hours and the nursing staff will watch the access site closely for any potential bleeding or swelling. You will have IV fluids for a while afterward and have your vital signs and heart rate/rhythm monitored. You will have an ultrasound of your heart at some point after the procedure to see that the closure device remains in proper position. You will be prescribed medications to prevent blood clots from forming such as aspirin or clopidogrel and will need a follow up appointment with your physician after your hospital discharge.