PFO & ASD Closure
Transcatheter Closure of Heart Defects
Minimally invasive procedures to close holes in the heart wall that can increase stroke risk or cause other complications.
What are PFO and ASD?
Patent Foramen Ovale (PFO) and Atrial Septal Defect (ASD) are both openings in the wall (septum) between the heart's two upper chambers (atria). While they may sound similar, they have different origins and characteristics.
Dr. Bleszynski has performed over 20 PFO closures during his fellowship training and continues to offer this procedure to patients in Las Vegas, using the latest techniques and closure devices.
Understanding PFO vs. ASD
Patent Foramen Ovale
- •A flap-like opening that normally closes after birth
- •Present in approximately 25% of adults (1 in 4 people)
- •Often doesn't cause symptoms
- •May be linked to cryptogenic stroke (stroke of unknown cause)
- •Can be associated with migraine headaches
Atrial Septal Defect
- •A true hole in the heart wall (tissue didn't form properly)
- •A congenital heart defect present from birth
- •May cause blood to flow between atria
- •Can lead to heart enlargement and rhythm problems
- •May cause shortness of breath and fatigue over time
Why Close a PFO or ASD?
PFO Closure May Be Recommended For:
- Patients who have had a cryptogenic stroke (stroke of unknown cause) and have a PFO
- Patients with recurrent strokes despite blood thinner therapy
- Certain patients with migraine headaches with aura
- Divers with decompression sickness
ASD Closure May Be Recommended For:
- Significant blood flow across the defect (significant shunt)
- Right heart enlargement due to the defect
- Symptoms such as shortness of breath or fatigue
- Prevention of long-term complications like heart failure or arrhythmias
The Closure Procedure
Both PFO and ASD can be closed using a minimally invasive catheter-based approach, avoiding open-heart surgery in most cases.
Access
A catheter is inserted through a vein in the leg (groin) and guided to the heart under X-ray and ultrasound guidance.
Crossing the Defect
The catheter is carefully advanced through the opening in the septum (the PFO or ASD).
Device Deployment
A closure device (a small, umbrella-like implant) is advanced through the catheter and positioned across the defect. The device has two sides that sandwich the septum.
Confirmation & Completion
Imaging confirms proper placement and closure. Over time, heart tissue grows over the device, permanently sealing the opening.
Benefits of Transcatheter Closure
Minimally Invasive
No open-heart surgery or chest incision
Quick Procedure
Typically 1-2 hours
Fast Recovery
Most return to activities within days
Short Hospital Stay
Same-day or overnight
Proven Technology
Thousands of successful closures worldwide
Permanent Solution
Device becomes part of the heart wall
Recovery & Follow-Up
After PFO or ASD closure, you'll typically stay in the hospital for observation overnight or go home the same day, depending on your specific situation.
Key aspects of recovery include:
- Taking antiplatelet medication (aspirin and/or clopidogrel) for 3-6 months to help the device heal in place
- Avoiding strenuous activity for a few weeks while the device integrates
- Follow-up echocardiogram to confirm proper healing and closure
- Antibiotic prophylaxis before dental procedures for the first 6 months
Most patients can return to normal activities within a week and resume exercise within a month.
Frequently Asked Questions About PFO Closure
What is the difference between a PFO and an ASD?
A PFO (Patent Foramen Ovale) is a flap-like opening between the heart chambers that normally closes after birth but remains open in about 25% of adults. An ASD (Atrial Septal Defect) is a true hole in the heart wall that never formed properly. Both allow blood to pass between the upper heart chambers, but ASDs typically cause more significant blood flow issues and symptoms.
How do I know if I need PFO closure?
PFO closure is typically recommended for patients who have had a cryptogenic stroke (stroke of unknown cause) and are found to have a PFO. Testing includes a bubble study (echocardiogram with contrast) to detect the PFO. Your cardiologist and neurologist will work together to determine if closure is the right option for you based on the size of the PFO and your stroke risk factors.
Is PFO closure surgery?
No, PFO closure is not open-heart surgery. It is a minimally invasive catheter-based procedure. A small catheter is inserted through a vein in the leg and guided to the heart, where a closure device is placed across the PFO. Most patients go home the same day or the next morning with just a small puncture site in the groin.
How effective is PFO closure at preventing stroke?
Clinical trials have shown that PFO closure significantly reduces the risk of recurrent stroke compared to medication alone in appropriate patients. Studies show a 50-60% reduction in stroke recurrence. The procedure is most effective in patients with larger PFOs or those with an associated atrial septal aneurysm.
What is recovery like after PFO closure?
Recovery is typically quick. Most patients go home the same day or next morning. You will take aspirin and another blood thinner for 3-6 months while the device heals into place. Light activities can resume in a few days, and most patients return to full normal activities within 1-2 weeks. Follow-up imaging confirms proper healing.
Structural Heart Specialist
Quick Facts
- Procedure Time
- 1-2 hours
- Anesthesia
- General or conscious sedation
- Hospital Stay
- Same-day to overnight
- Full Recovery
- 1-4 weeks
Stroke Prevention
Clinical trials have shown PFO closure can significantly reduce the risk of recurrent stroke in appropriate patients compared to medication alone.
Had a Stroke of Unknown Cause?
If you've experienced a cryptogenic stroke, PFO closure may help prevent future events. Schedule a consultation to learn more.
Schedule Consultation(702) 805-5678