A Patent Foramen Ovale (PFO) or Atrial Septal Defect (ASD) are holes in the tissue between the top chambers (atria) of the heart. This can allow blood clots, de-oxygenated blood and other elements to ‘bypass’ the lungs and travel to other parts of the body, potentially causing strokes, migraines, diving decompression illness ‘the bends’, breathlessness and strain on the heart.
PFOs are very common (about 20% of the general population have a PFO) and so are not routinely closed unless they cause problems such as a stroke. PFOs do not cause chest pain, breathlessness or
strain on the heart.
Atrial Septal Defects on the other hand are much less common but almost always require closure to improve symptoms and reduce the strain on the heart.
Dr Hilling-Smith is a proctor (teaches other cardiologists) for both procedures and runs the annual Australian PFO Masterclass.
• You will be asked to arrive at the hospital on the morning of your procedure.
• You mustn’t eat or drink that morning.
• You do not need to take any of your usual medications that morning; we will give you any medication you require with a glass of water.
• The closure procedure is performed under a general anaesthetic and so our friendly anaesthetists will drift you off to sleep at the start of the procedure.
• The closure device is inserted through a 4 mm tube in the vein at the top of the leg. There is no cutting involved. A camera (trans-oesophageal echocardiogram) is placed down your throat whilst you are asleep to help Dr Hilling-Smith guide the closure device into place.
• The procedure usually takes about 45 minutes.
• You must stay 1 night in hospital after PFO / ASD closure.
• You may well have a sore throat due to the breathing tube and camera and a small bruise in the groin.
• You will be placed on gentle blood thinners (aspirin and clopidogrel) for about 3 months and antibiotics for a week.
• You will have an echocardiogram the following morning and can usually go home at lunchtime.
• You are not allowed to drive for 2 days.
• You cannot do anything strenuous such as lifting (anything more than 10kg), going to the gym or swimming until your clinical review and check at 6 weeks post-operative. This is to avoid any straining or putting pressure on the chest cavity whilst the device settles in.• You will have a clinical review and echocardiogram 6 weeks post-procedure.
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