Whether you’re a young patient who’s recently suffered from a stroke, or are experiencing decompression illness when diving, you may need a PFO closure. Learn what a PFO closure is, whether you need it, what the procedure involves and what happens next. With our patient-centered approach, you’ll get a quick treatment plan that works around you. Choose cardiologists who care and book your consultation with Dr Malik today.
What is a PFO closure?
A PFO (Patent Foramen Ovale) is a connection between the left and right collecting chambers of the heart – It is a ‘flap’ and not a ‘hole’. It’s a remnant of foetal circulation (when its purpose is to provide a bypass for the lungs as they are not used in the womb).
About 25% of the general population have a PFO and it is a normal finding in most people with no implications. Closure of a PFO is only recommended in limited situations and can be carried out using catheters and small umbrella-like devices with a 95% chance of successful closure.
Do I need PFO closure?
The UK government’s NICE guidelines publish recommendations for who should have their PFO closed.
- Young patients who have suffered a stroke. This is probably the most common reason for closing the PFO, as it tends to half the risk.
- Divers with recurrent paradoxical emboli (decompression illness, or “the bends”).
- There’s potentially a connection between PFO and migraines, but more research is needed to clarify the link. If you suffer migraines, there’s not yet a definite indication for PFO closure.
What does the procedure involve?
Your PFO closure will be carried out by Dr Malik using general anaesthesia. You won’t feel a thing during the procedure, and as it is done as a day-case procedure you’ll be in and out on the same day!
The procedure is broken down into some simple steps:
- First, you’ll be admitted to the ward and taken to the operating room.
- A breathing tube will be placed to give the anaesthetic and a transoesophageal echo (TOE) tube will be placed into your stomach.
- A pipe will be passed from a needle puncture in your leg to the heart.
- The operation is guided by X-rays from the outside, and by ultrasound pictures from a TOE probe. This guides a wire which is passed across the hole in the heart.
- A small balloon lays inside the catheter which is used to measure the exact size of the hole so Dr Malik can choose the best device to close it.
- A plastic tube is passed over the wire and an umbrella device is placed across the hole through this pipe. This acts like a “cuff-link” to seal down the PFO flap.
- The pipes are taken out and the hole in your leg (where the pipes have been) is pressed on to stop the bleeding.
What are the risks?
Whilst complications are rare, the following complications are possible:
- Bleeding. As your blood is thinned during the procedure, you could potentially suffer bleeding problems from the leg (and occasionally internally). Sometimes blood leaks into the bag surrounding the heart and a further procedure will be needed to help release it. Very rarely emergency surgery is required.
- Heart rhythm problems. Including palpitations (which may just be an awareness of your own heartbeat) or extra heartbeats. These usually settle with medication.
- Stroke. If a small clot forms on the device or any of the pipes and moves to the brain, you could potentially have a stroke.
- Device detachment. If the umbrella moves, it has to be recaptured. If it cannot be recaptured, you may need surgery to remove it.
The good news is the overall complication rate is about 1-2% after the procedure, and death is very rare!
Watch Dr Malik carrying out a PFO closure!
What happens after the procedure?
You should take one week off work, and avoid gym workouts that week. There won’t be any sutures to remove, but please keep the tiny cut in your groin clean and dry.
You should get back to full activity one week later. You will need to take medication during this time, and you’ll attend a check-up appointment with Dr Malik a few weeks later. He will reassess your PFO with a bubble echocardiogram and decide if any further care is needed.
Ready to book your private PFO closure?
Get seen quickly
As we’re a private clinic, your appointments work around you. You’ll soon have your PFO closed so you can start enjoying life again.
Private PFO closures are covered by most private medical insurance policies, but please contact your insurance company prior to your appointment to obtain your pre-authorisation code to speed things up.
Our price list is available on request and is on display in our waiting area. For an estimation of costs please get in touch.
Why choose London Cardiovascular Clinic?
- We offer a patient-centred approach, so you’ll feel looked after and have all your questions answered
- Choose from our flexible appointment times and get seen at your convenience
- Personalised treatment plans
- Get consultancy & treatment from London’s top cardiologists – each with their own special interests
- You’ll experience a much more welcoming and relaxing experience at our private clinic than you would elsewhere
- Video resources to help you further understand your condition and the procedures involved