Patent Foramen Ovale (PFO) Repair

Fixing a Hole in the Heart Without Surgery

A foramen ovale is a small, flap-like hole that is naturally present in an unborn baby’s heart. The foramen ovale is between the atria, the two upper chambers of the heart. This hole in the wall of tissue that separates the atria should naturally close shortly after the baby is born. In 20 to 25 percent of people, the hole doesn’t close completely and allows blood to continue to cross between the two chambers.

Most PFOs cause no symptoms and do not require any treatment. However, some clinical studies have shown that PFOs are more common in patients who have certain medical conditions and may benefit from a closure procedure.

The best information on these PFO-related illnesses is in the treatment of unexplained (also called cryptogenic) strokes. Studies have found that PFOs appear to be more common in patients who have had unexplained strokes. In these cases, small blood clots that would normally stay on one side of the heart may pass through a PFO and travel to the brain to cause a stroke. In some cases of unexplained strokes, a PFO closure procedure might be recommended.

Other medical problems that may be related to PFOs are migraine headaches, decompression illness in divers, and rarely, a condition called hypoxemia (low blood oxygen levels).

A PFO can typically be closed using a nonsurgical procedure. A specially trained physician inserts a tube called a catheter into a blood vessel in the upper part of the leg. The catheter carries a closure device to the heart that can be placed across the hole to seal it closed. Tissue gradually grows over the device to further seal the PFO.

Is PFO Catheter Repair Right for You?

If your doctor has identified a PFO and thinks you are at risk for forming blood clots or having a stroke, you may be a candidate for a PFO transcatheter repair.

Until the early 1990s, closing a PFO nearly always required open-heart surgery. Now, catheter repair is the most frequent treatment.

Sometimes blood-thinning medicines will reduce the risk of clot formation. After taking a complete history of your symptoms and conducting a thorough evaluation with imaging tests, your doctor will recommend if a PFO repair is necessary and whether a repair via catheter or surgery is right for you.

Why Choose University of Iowa for Your Heart Care

It’s important to have a medical team who can detect and thoroughly evaluate a PFO correctly. You also want to select a center that can offer you experienced physicians, surgeons, and staff as well as the broadest range of treatment options.

The University of Iowa Heart and Vascular Center has a highly skilled team of board-certified cardiologists and cardiac surgeons with specialized training in repairing PFOs. We tailor treatment to your individual needs, offering both catheter-based and surgical options for our patients who require PFO repair. 

People come from across Iowa and the Midwest to receive care for the most complex structural problems in the heart. Our patients benefit from our experience and our excellent outcomes.

Experience does matter.

Since our first PFO catheter repair procedure more than 20 years ago, we have evaluated and treated hundreds of patients with this problem. We are one of the most experienced centers in Iowa performing PFO closure on adults. Most of these procedures can be performed in less than one hour without the risk of general anesthesia. Most patients can return home the day of their PFO procedure.

Greater experience translates to better outcomes.

The experience we’ve gained from our high volume of PFO procedures has helped us to achieve successful outcomes that lead to improved heart function and a lower risk of stroke for our patients.

Our team includes a wide range of specialists.

Our PFO program offers the expertise of:

  • Interventional cardiologists with specific structural heart disease training and experience
  • Adult and pediatric cardiac surgeons
  • Specialists in cardiac ultrasound, MRI, and CT scans 

All of our specialists are University of Iowa physician faculty.

Our patient care benefits directly from access to the latest medical procedures and technology, as well as from our participation in cutting-edge national and international research. Our doctors are among the first in their field to access the newest technologies and adapt to ever-evolving top standards of care.

Care Team