Patent foramen ovale (PFO)
Mayo Clinic Healthcare cardiologists have expertise in patent foramen ovale (PFO). The condition leaves a flap-like hole between the two upper heart chambers after birth.
Before birth, babies have an opening called the foramen ovale that helps blood flow in the womb. It usually closes soon after birth, but if it stays open, it becomes a patent foramen ovale.
Most people with a PFO never notice symptoms, and it is often discovered during tests for other health problems. And while a PFO usually doesn't present health problems, in some cases, a PFO can occur along with other heart conditions.
Complications linked to a PFO include:
- Low blood oxygen. In rare situations, blood may bypass the lungs, leading to lower oxygen levels, a condition called hypoxaemia.
- PFO and stroke risk. A small blood clot may pass through the PFO to the left side of the heart and then travel to the brain, where it can block blood flow and cause an ischaemic stroke.
Research has found that people with unexplained strokes or migraines with aura may have PFOs more often, but the connection is uncertain and often coincidental.
Diagnosing a PFO
Mayo Clinic Healthcare specialists can perform a variety of tests to understand the exact nature of your PFO. They use mainly an echocardiogram, a test that uses sound waves to create moving images of the heart. It shows the heart’s structure and how blood flows through its chambers and valves.
And because we house the necessary tests, you can receive results usually within a few days of visiting the clinic.
Transthoracic echocardiogram
This common type of echocardiogram takes images from outside the chest. A device called a transducer sends sound waves into the body, and a computer turns the returning echoes into pictures.
Two approaches can help identify a PFO:
- Colour doppler. This technique shows changes in blood flow using colour. It may reveal blood moving between the upper chambers if a PFO is present.
- Saline contrast (bubble) study. During this test, a salt-water mixture with tiny bubbles is injected into a vein. If the bubbles appear in the left side of the heart, they may have passed through a PFO.
Transoesophageal echocardiogram
To develop a clearer picture of our PFO, your specialist may recommend a transoesophageal echocardiogram. The procedure places a thin tube with an ultrasound probe down the throat into the oesophagus to take detailed images from close to the heart. This method provides a very accurate view of a PFO.
Management for a PFO
Most people with a PFO do not need any treatment, especially if the opening is found by chance during another test. However, if your PFO requires treatment, your Mayo Clinic Healthcare specialist will work with you to tailor a plan to exact type of PFO and health goals.
Mayo Clinic Healthcare may provide medication management to address your PFO. For instance, blood-thinning medicines can lower the chance of clots crossing the PFO, which is particularly important for people who have had a stroke.
- To ensure you get the exact care you need, your Mayo Clinic Healthcare consultant may refer you to a trusted health professional for advanced procedures, such as: Transcatheter PFO closure (device closure). This PFO closure procedure uses a thin tube, inserted through a vein in the groin, to place a small device that seals the PFO. This method is similar to an ASD closure procedure, which treats a different type of heart opening. Complications are uncommon but can include tears, movement of the device or irregular heart rhythms.
- Surgical closure. A surgeon closes the PFO with stitches. This operation can be done through a small incision and may use robotic tools. If heart surgery is already planned for another reason, closing the PFO at the same time may be recommended.
Book your appointment
If you're experiencing symptoms from a PFO or want a second opinion, contact us today. Our experienced PFO specialists near you can help by providing expert PFO care.
Request an appointment online or call us at +44 (0) 207 871 2575.