PFO and ASD Closure

Percutaneous closure of PFO (Patent Foramen Ovale) and ASD (Atrial Septal Defect) is a minimally invasive procedure used to correct an abnormal opening in the septum (wall) between the two upper chambers of the heart (atria), which may allow abnormal blood passage between the right and left sides of the heart.

What is the difference between PFO and ASD?

PFO (Patent Foramen Ovale):
A small flap-like opening present from birth that fails to fully close in some individuals. It usually causes no symptoms, but in selected patients, it can increase the risk of cryptogenic stroke (stroke with no identifiable cause).
ASD (Atrial Septal Defect):
A true structural hole in the atrial septum (typically larger than a PFO), which may lead to excessive blood flow to the right side of the heart, potentially causing fatigue, shortness of breath, arrhythmias, heart enlargement, and pulmonary hypertension over time.

Why is the closure performed?

The procedure is recommended to:

Reduce the risk of stroke (in selected PFO patients)
Prevent long-term cardiac and pulmonary complications in patients with a significant ASD
Normalize blood flow through the heart
Improve symptoms such as fatigue, shortness of breath, or palpitations

How is the procedure performed?

The closure is done without open-heart surgery, using a catheter-based approach:

Venous access:
A thin catheter is inserted into a vein in the groin (or sometimes the neck).
Advancement to the heart:
The catheter is guided to the heart using X-ray and echocardiographic imaging.
Device deployment:
A small double-disc closure device (often described as an “umbrella” device) is delivered through the catheter and positioned to seal the opening from both sides.
Device release:
The device is released and remains permanently in place, gradually integrating into the heart tissue.
Final assessment:
Imaging confirms proper positioning before removing the catheter.

How long does the procedure take and what type of anesthesia is used?

Duration: 30–60 minutes
Anesthesia: Local anesthesia with light sedation (patient remains relaxed and breathing spontaneously)

Recovery and follow-up

Hospital stay: Usually 24 hours
Return to daily activities: Within a few days
Medications: Typically antiplatelet therapy (e.g., aspirin and/or clopidogrel) for a few months
Follow-up: Clinical visits and echocardiography to confirm stable device position and closure

What are the risks?

The procedure is considered very safe, with a low complication rate. Rare risks include:

Minor bruising at the access site
Temporary arrhythmias
Small pericardial effusion
Very rarely, device displacement (usually manageable)

Percutaneous closure of PFO and ASD is a safe, effective, and minimally invasive treatment that can significantly reduce the risk of stroke and prevent long-term heart complications, improving both health outcomes and quality of life.