About PFO Closure
- How do I know which treatment option is right for me?
Doctors likely found your PFO when trying to find the cause of your stroke. Often, the cause of stroke is never known. These strokes are called cryptogenic (Crypto means hidden. Gen means cause.) Doctors are aware that a PFO can lead to a stroke. To reduce the risk of another stroke, your doctors may recommend closing your PFO with a PFO occluder device. PFO occluder devices have been proven safe and effective in many large studies.1,2,3
- Mas J-L, Derumeaux G, Guillon B, et al. Patent foramen ovale closure or anticoagulation vs. antiplatelets after stroke. N Engl J Med. 2017; 377: 1011-21.
- Saver JL, Carroll JD, Thaler DE, et al. Long-term outcomes of patent foramen ovale closure or medical therapy after stroke. N Engl J Med. 2017; 377: 1022-32.
- Søndergaard L, Kasner SE, Rhodes JF, et al. Patent foramen ovale closure or antiplatelet therapy for cryptogenic stroke. N Engl J Med. 2017; 377: 1033-42
- What do I need to do before the PFO closure procedure?
Be sure to talk with your doctor about any medication you may be taking, as they may advise you to adjust your medication before the procedure. Your doctor may tell you not to eat or drink anything after midnight prior to the procedure. You should arrange for a ride to and from the hospital and ask someone to help you at home (if necessary).
- What happens during the PFO closure procedure?
This minimally invasive procedure will take place in a heart catheterization laboratory. Before beginning the procedure, you will receive a sedating medication to help you relax and a local anesthetic so that you don’t feel any significant discomfort. The catheter-based procedure involves making a tiny cut, typically in the right groin area, and inserting a small tube to guide the PFO occluder through the blood vessels to close the PFO within your heart.
Once the PFO occluder is placed across the PFO, the cardiologist will carefully study its position using cardiac imaging tools. When the cardiologist is satisfied with the position of the device, it will be released to remain permanently in the heart, and all catheters will be removed.
- What happens after the PFO closure procedure?
After the procedure, your medical team will discuss an after-care plan with you. You should expect to be discharged from the hospital within 24 hours. You may be prescribed aspirin (81 to 325 mg) and clopidogrel (75 mg) to be taken daily for one month after the procedure, followed by daily aspirin (81 to 325 mg) alone for at least five additional months. Your doctor may prescribe additional medication beyond six months. You will have an echocardiogram at six months so that your doctor can make sure that your occluder is properly set.
Regular check-ups with your doctor are very important. Call or see your doctor whenever you have questions or if you have any unusual problems such as bleeding, pain, discomfort or changes in your overall health.
You will also be given a PFO occluder implant card. Please carry it with you at all times and tell other doctors that you have had the procedure before any medical, dental or MRI (magnetic resonance imaging) procedures. Failure to do so may result in health problems or damage to the occluder.
- How long after surgery do I need to wait to resume normal activity?
It is recommended that patients avoid strenuous physical activity for at least two weeks after occluder placement. Your doctor will provide you with more information.
- Can a PFO occluder cause problems in certain places or situations?
Your PFO occluder will not be affected by household appliances or security systems. Tell all your doctors, including your dentist, that you have a PFO occluder. If you need medical imaging, tell the technician that you have a PFO occluder. The device may reduce the clarity of your medical images.
- Should I be concerned about having a metal device in my heart?
The PFO occluder contains a nickel-titanium alloy. This is considered safe for most people. It may not be the right choice for people who are allergic to nickel or who have allergies to metal. Talk to your doctor to determine the right treatment option for you.