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If you were born with a hole in your heart that never closed, known as a patent foramen ovale (PFO), you may need a procedure to correct it. Penn Medicine cardiologists use interventional techniques to close a patent foramen ovale without opening your chest for surgery.
A patent foramen ovale may be difficult to confirm on a standard echocardiogram. Your provider may recommend this test to get a closer look at the heart. A transesophageal echocardiogram takes pictures of the heart from inside the body. It's considered the most accurate way to diagnose a patent foramen ovale.
Having a PFO as an adult or older child is not normal. But it occurs in many people. It may be slightly more common in younger adults compared with older adults.
PFO closure may be offered to younger patients (e.g., <30 years) with a single, small, deep stroke (<1.5 cm), a large shunt, and absence of any vascular risk factors that would lead to intrinsic small-vessel disease such as hypertension, diabetes, or hyperlipidemia (level C).
A healthcare provider may recommend a PFO closure procedure if: You've had a transient ischemic attack (TIA) more than once. You've had cryptogenic (from an unknown cause) strokes more than once. You have a low level of oxygen in your blood.
An echocardiogram can be done to diagnose a PFO. If the PFO is not easily seen, a cardiologist can perform a "bubble test." Saline solution (salt water) is injected into the body as the cardiologist watches the heart on an ultrasound (echocardiogram) monitor.
An echocardiogram can be done to diagnose a PFO. If the PFO is not easily seen, a cardiologist can perform a "bubble test." Saline solution (salt water) is injected into the body as the cardiologist watches the heart on an ultrasound (echocardiogram) monitor.
Rarely, a patent foramen ovale can cause a significant amount of blood to go around the lungs. This lowers blood oxygen levels, a condition called hypoxemia. Stroke. Sometimes small blood clots in veins may travel to the heart.
During the procedure, an interventional cardiologist: Makes a tiny incision in your groin and inserts a catheter into a blood vessel. Uses ultrasound imaging to get a closer view of the PFO. May guide a deflated balloon through the catheter and move it to the PFO.