PFO Closure

PFO refers to “patent foramen ovale,” a small hole between the top chambers of the heart. This connection is present in all people in utero, but usually closes after birth. In certain cases, blood clots can travel through this small connection and cause a stroke. These patients may benefit from PFO closure. Dr. Raney received expert training in the PFO and ASD (atrial septal defect) closure at the prestigious Scripps Clinic in San Diego, and performs PFO closure at St. Joseph and St. Jude hospitals. Dr. Raney is the highest volume operator for PFO closure in Orange County.

Which patients will need PFO closure?

A PFO is present in up to 30% of the population, and only a small number of these will need to be closed. PFO closure is generally recommended for patients with a PFO who have had a stroke and no other obvious cause for the stroke. The decision to perform PFO closure is complex, and Dr. Raney works with a neurologist on each case to make sure the procedure is recommended.

How is the PFO closure procedure performed?

General anesthesia is used in most cases to ensure the patient is comfortable during the procedure. A small catheter (tube) is inserted into the femoral vein, which is a blood vessel near the hip. This small tube is advanced across the PFO under live ultrasound guidance. The PFO occlusion device is then advanced through the tube into the left atrium. The first disc is deployed in the left atrium. The device is then pulled back, and a second disc is deployed in the right atrium. The PFO connection is then closed by the 2 discs. Once the appropriate position is confirmed, the device is left in place.

What is the recovery from a PFO closure procedure?

After the procedure, patients lie flat for 4-5 hours, and can then sit upright in a chair. Patients can be discharged the same day or after a one-night observation in the hospital.

After discharge, patients can resume everyday activity, including walking. We recommend no heavy lifting for at least one week to give the vein time to heal. Bruising around the femoral vein is normal, as a small amount of blood may leak out into the soft tissue during the procedure. It is ok to shower, but we recommend avoiding a bath until the puncture site has healed.