From an interview with
Dr. Brian Blaker
McLeod Cardiology Associates – Florence

Before a baby is born, it has a small hole or flap in the heart that doesn’t fully close; that’s to allow blood flow exchange within the heart to bypass the baby’s lungs in utero. Once they’re born and they start breathing on their own, that flap or hole usually seals off. However, in one out of four individuals, there remains a small connection in the upper chambers of the heart. McLeod Interventional Cardiologist Dr. Brian Blaker explains more about this condition.

“We call this a Patent Foramen Ovale or PFO. For most people, it’s a very benign finding that they may never know they have. They’re born with it, they live their whole life, and it never causes them any issue. However, in a small percentage of patients that have a PFO and suffer a stroke of an unknown cause, it’s possible that the PFO may have led to or contributed to their risk of stroke. And so, in those patients, they may benefit from being evaluated for the possibility of undergoing what’s called a “PFO closure” to seal off the hole in the heart.

If you’ve never had any stroke or stroke-like symptoms, then you may not need any evaluation. It’s really for patients who have had a stroke or who have undergone an echocardiogram, which is an ultrasound of the heart, to evaluate the heart structures and function. And using that ultrasound, we’re able to assess for any abnormal connections in or around the heart, such as a PFO.

For most people who are found to have a PFO, it may be an incidental finding, meaning they had an ultrasound for some other reason and their physician finds a PFO. For those people, we’re happy to evaluate them, but they may not need to have a corrective procedure. For other patients who have suffered a stroke and are also found to have a PFO, they may benefit from closing that PFO. In the past, that was done with open heart surgery; a surgeon would open up the heart and put a small stitch in to seal off the hole. Now we’re able to use a minimally-invasive approach, where we insert a small catheter through the vein in the right groin, and we advance a device called a PFO closure device. We implant it along the connection between the upper chambers of the heart, which seals the hole. The procedure generally takes about 45 minutes, and most patients are able to go home the same day or the next day. It’s a good alternative to surgery for many of our patients.

Like anything, procedures involve risks, and even though this is a very safe procedure, we want to make sure we’re doing it in the right population – in the right patient who’s going to benefit. And so, I would encourage any patient who has had a stroke or who’s been found to have a PFO to ask their doctor or cardiologist if they might be a candidate. We evaluate each patient individually, ensuring they don’t have any other causes of stroke. Again, for patients who have had an unexplained stroke, particularly at a younger age, and they also have a PFO, closing the PFO can help reduce their risk of future stroke.

People should know that a PFO is something a person is born with, and it’s one of the few things that lifestyle doesn’t really impact. It just happens without reason; it’s sort of the luck of the draw. People do not need to be overly scared or fearful if they’re told they have this; just to be aware. That way, if they know they have a PFO and they do have a stroke or, in some patients, really severe migraine headaches, those patients may have an option for a minimally invasive closure of the PFO to help reduce their risk of future strokes.”

To learn more, speak with an interventional cardiologist near you.