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Structural Heart Disease: PFO/ASD Closure

Individuals may be born with structural heart disease may or "holes" in the heart that lead to potentially harmful alterations in blood flow. The heart's atrial septum is the tissue membrane that divides the left and right atrial chambers. A hole in this tissue is termed an atrial septal defect (ASD). ASDs may be diagnosed by echocardiography if a routine physical exam reveals that a patient has a heart murmur. If left untreated, ASDs can lead to heart failure, and in certain instances cause severe elevation in pulmonary (lung) artery pressure.

ASDs may be treated by undergoing open heart surgery, but certain defects can be closed less-invasively by a heart catheterization procedure performed through a catheter in the leg). Sansum Clinic cardiologists specialize in ASD closure to those patients who will benefit from the procedure.

Much more common than an ASD is a patent foramen ovale (PFO). PFOs tend to be smaller holes than ASDs, are very common, and are present in one out of four people. In most people, PFOs remain asymptomatic, and nothing is required for their treatment.

In some patients with PFOs, an embolism ("blood clot") passing from the right heart to the left heart through the PFO opening can be transported to the brain, resulting in a debilitating stroke. Closure of PFOs may also benefit patients with severe migraine/vascular headache, scuba divers suffering from decompression sickness and air embolism.

A catheter is inserted through the leg/groin and positioned across the hole in the patient's heart. A closure device is then deployed which resembles a small "plug" covering the hole. The heart will then heal around the plug over the ensuing months until no hole remains and the lesion is fixed. Recovery from the procedure is rapid and patients usually can return home the same or following day.