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A Patent Foramen Ovale (PFO) is a small hole in the heart that did not close the way it should. Before birth, oxygen rich blood from mother travels through a tiny hole, with a flap, in the baby’s heart from right upper to the left upper chamber. When the baby takes the first breath after birth, the flap seals the hole. In approximately 1 out of 4 people, the flap does not seal the hole which is called Patent Foramen Ovale (PFO).
"That's usually not a problem, except that some people may be prone to form a blood clot in their venous system. At times these clots can travel through this unsealed hole from right upper to the left upper chamber of heart when they cough, or throw up or bear down," says M. Ziaul Hoque, MD, an interventional cardiologist at Indiana University Health Arnett Hospital.
If a clot travels from the left upper chamber of the heart to the brain, it can cause a stroke. Stroke is a devastating event for patients and their families. Each year in the United States, more than 800,000 people experience a stroke. It is the fourth-leading cause of death and the leading cause of serious, long-term disability in adults.
An atrial septal defect (ASD) is a hole in the wall between the two upper chambers of the heart. The condition may be present at birth. It may increase the amount of blood that flows through the right side of the heart into the lungs, causing high pressure to develop in the blood vessels of the lungs, a condition known as Pulmonary Hypertension. This may increase the load on the right side of the heart, which needs to work harder and eventually become weak.
Doctors at IU Health Arnett may fix PFO and ASD with catheter-based closure devices. Advancements in device technology and image guidance now permit the safe and effective catheter-based closure of PFO and ASD. The procedure is done by advancing a catheter through a vein in the leg up to the heart. A disc is deployed that closes the flap or the hole, reducing the risk of stroke or dysfunction of the right side of the heart.
"When the neurologist sits down with cardiologist to discuss stroke patients who have been found to have a PFO, we can assess if the common causes of stroke have been ruled out, and, if so, whether the PFO may have been related to the stroke. We can then decide whether the patient should be treated medically or the PFO should be sealed with a closure device" Dr. Hoque says. "We can discuss through a patient's history, exam and workup findings, and then arrive at the best treatment recommendation."
IU Health Arnett is the first hospital in the area to offer the Percutaneous Closure procedure, saving patients diagnosed with PFO or ASD the drive to Indianapolis.