ASD and PFO Closures

What are ASD and PFO Closures?

There are two types of holes in the heart – atrial septal defect (ASD) and patent foramen ovale (PFO). Both are holes in the wall tissue between the left and right upper chambers of the heart, called the septum. Individuals born with ASD have a genetic abnormality causing the septal tissue to incorrectly form between the heart’s two chambers. ASD holes can vary in size and severity of abnormal blood flow, related to the size of the hole. The foramen ovale is a hole between the two chambers of every growing baby’s heart. The hole has a purpose – to allow blood to bypass the lungs while the baby is in utero and the lungs aren’t functioning. In this way, blood arrives safely to the heart already oxygenated by the placenta. The foramen ovale completely seals shut in approximately 75 percent of babies within several months after birth. When it doesn’t close completely or can reopen in certain circumstances, it’s called a PFO.

What are the Symptoms and Risks of ASD and PFO?

Some people will show no signs of having a hole in their heart. Others may experience symptoms that can negatively impact their quality of life, including:

• fatigue
• heart murmur
• heart palpitations
• migraine headaches
• shortness of breath
• swollen legs, feet or abdomen
• stroke

Many strokes are caused by blood clots in the brain that cut off important oxygen and blood flow. In people with PFOs, small blood clots that would normally be absorbed by the lungs can flow through the hole, carrying it out into the body. Even very small clots that reach the brain can lead to a stroke. In fact, the American Stroke Association estimates that 100,000 Americans suffer a PFO-related stroke each year.

Who Should Consider an ASD or PFO Closure?

In many cases, a hole in the heart requires no treatment. Until recently, those who did experience symptoms were limited to blood thinning medications as the main treatment option. Those with ASD who have developed heart failure or arrythmia may consider an ASD closure to help relieve negative symptoms, like dizziness, fatigue or shortness of breath.

Both ASD and PFO increase your risk of a stroke, so you and your cardiologist may decide that a closure is right for you to reduce that risk. Half of all ASDs close on their own or are so small that no treatment is needed. Medium to large ASDs that need treatment can be repaired using a catheter procedure or open-heart surgery. As part of your comprehensive evaluation, we work with a team of specialists including neurologists, radiologists and imaging experts to determine the best treatment plan for your unique condition.