About PFO Closure
- How do I know which treatment option is right for me?
If you have been diagnosed with a patent foramen ovale (PFO) and have had an ischemic stroke of unknown cause, you are at risk of another stroke. To reduce the risk of another PFO-associated stroke, your doctors may recommend closing your PFO with a PFO occluder. Devices like these have been used to treat hundreds of thousands of patients around the globe, and are supported with many large clinical studies.1,2
- Mas JL, Derumeaux G, Guillon B, et al. Patent foramen ovale closure or anticoagulation vs. antiplatelets after stroke. N Engl J Med. 2017; 377:1011-21.
- Saver JL, Carroll JD, Thaler DE, et al. Long-term outcomes of patent foramen ovale closure or medical therapy after stroke. N Engl J Med. 2017;377:1022-32.
- What do I need to do before the PFO closure procedure?
When scheduling your procedure:
Tell your doctor what medicines you take. Include the dose for each medicine. Your doctor may ask you to change your medicine routine before your procedure.
The night before your procedure:
You may be told not to eat or drink anything after midnight the night before your procedure. Follow your doctor’s advice about eating, drinking, and taking medicine.
The day of your procedure:
Do not drive yourself to the hospital. Have someone else drive you there and home. You may want to ask someone to help you at home.
- What happens during the PFO closure procedure?
First you will receive a sedating medicine to help you relax. You will also receive a local anesthetic. Once you are relaxed and comfortable, your doctor will begin the procedure.
Your doctor will make a small incision (cut) and insert a tube called a catheter into your groin area. The PFO occluder travels inside the catheter. Your doctor will guide the catheter through your body to your heart.
Then your doctor will place the PFO occluder across your PFO. Cardiac imaging tools will help your doctor confirm that the occluder is in the right position before removing the catheter. Then your doctor will remove the catheters. The occluder will stay in your heart.
You will be resting in the recovery room in about 2 hours.
PFO closure is not open heart surgery and is considered a 'minimally invasive' procedure.
- What happens after the PFO closure procedure?
You should expect to be home within 24 hours. Your doctor will talk to you about your care before you go home. Your doctor may recommend a routine like the one described here.
For one month after your procedure:
- Aspirin (81 to 325 mg) every day
- Clopidogrel (75 mg) every day
For at least six months after your procedure:
- Aspirin (81 to 325 mg) every day
- Additional medicine prescribed by your doctor
Six months after your procedure:
- An echocardiogram
- Visit your doctor for regular check ups.
- Contact your doctor if you have any bleeding, pain, discomfort, or changes in your overall health.
- For your safety and to avoid damage to your occluder:
- Tell all medical professionals that you have had PFO closure.
- Talk about your implant BEFORE you have any imaging procedures: medical, dental, or MRI (magnetic resonance imaging).
- After the procedure, when can I resume normal activities?
You should avoid strenuous physical activity for at least 2 weeks after your procedure. Your doctor will provide you with more information.
- Can a PFO occluder cause problems in certain places or situations?
Your PFO occluder will not be affected by household appliances or security systems. Tell all your doctors, including your dentist, that you have a PFO occluder. If you need medical imaging, tell the technician that you have a PFO occluder. The device may reduce the clarity of your medical images.
- Should I be concerned about having a metal device in my heart?
Most PFO occluders contain a nickel-titanium alloy. This is considered safe for most people. It may not be the right choice for people who are allergic to nickel or who have allergies to metal. Talk to your doctor to determine the right treatment option for you.