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Percutaneous Patent Foramen Ovale Closure (PFO repair)

Percutaneous Patent Foramen Ovale Closure

Before birth, babies have a small opening in the wall between the two upper chambers of the heart (the atria). This opening, called the foramen ovale, helps blood bypass the lungs, which are not used until after birth. Normally, this hole closes shortly after birth. However, in about 25% of people, it remains open—this is known as a patent foramen ovale (PFO).

If the hole stays open, it can allow blood or small clots to pass from the right atrium to the left atrium, which may increase the risk of stroke or other complications.

Additional tests that may be needed:

Depending on your condition, your cardiologist may also recommend one or more of the following tests:

  • Echocardiogram: An ultrasound scan that creates images of your heart using sound waves.
  • Angiogram: A catheter is used to inject contrast dye into your coronary arteries while X-ray images are taken. This helps assess heart size and function.

What Happens During the Procedure?

  • You will have canula or drip placed in your arm to give medications.
  • A local anaesthetic will be used to numb the area where the catheter (a thin, flexible tube) is inserted—usually in your groin.
  • You may also receive a sedative to help you relax.

Using the catheter, your cardiologist will guide a small device called a septal occluder into your heart. This device acts to “sandwich close” the hole. Once it is in the right position, the catheter is removed, and the entry site is sealed.

You will be monitored in a recovery area or the Cardiac Care Unit (CCU), and most patients stay overnight.

Common Risks

  • Minor bruising at the site where the catheter was inserted.
  • Temporary abnormal heart rhythms, which usually resolve on their own.
  • Major bruising or swelling (haematoma) around the groin or arm.
  • Bleeding at the catheter entry site
  • Changes in blood pressure, either high or low
  • Sore throat from the anaesthetic tube or ultrasound probe used during the procedure.
  • Increased lifetime exposure to radiation, due to imaging used during the procedure.

Uncommon Risks

  • Stroke or transient ischaemic attack (TIA), which may result in long-term disability.
  • Incomplete closure of the PFO, which may require further treatment or surgery.
  • Allergic reaction to the contrast dye used during imaging.
  • Blood clots (embolism) that may form and travel from the catheter—treated with blood thinners.
  • Injury to blood vessels or nerves in the groin or neck, which may require surgical repair.
  • Tear of the oesophagus, vein, or heart from imaging equipment—this is rare but serious.

Rare Risks

  • Persistent abnormal heart rhythm that may require electrical correction (cardioversion)
  • Deep vein thrombosis (DVT)—a clot in the leg that may travel to the lungs.
  • Device infection, which would require open-heart surgery and antibiotics.
  • Dislodgement of the closure device, possibly requiring surgical intervention
  • Puncture of the heart, leading to blood accumulation around the heart—requires emergency surgery.
  • Heart attack
  • Skin injury from radiation exposure
  • Air embolism, which may require oxygen therapy.