Your doctor has found a small hole in your heart. This hole is called a patent foramen ovale (called a PFO) or an atrial septal defect (called an ASD). This hole is between the right and left atria (upper chambers) of your heart.

Your doctor wants to close the small hole using an implant. The implant looks like two small fabric umbrellas, one on each side. Over time, the tissue around the hole grows into the fabric and the implant becomes a permanent part of your heart.


(Illustration courtesy of Allina Health System, © 2002)

A cardiologist uses a catheter (small, narrow tube) to place the implant in the hole. The procedure is called a transcatheter hole closure. You would have this instead of open heart surgery. Your doctor will talk with you about the risks and benefits of the procedure. The procedure is done in the Cardiovascular Lab.

• Do not eat or drink anything after midnight before the procedure.
  
  
• You may take small sips of water with your medicines.
  
  
• Tell your doctor if you have an allergy to contrast dye, iodine or shellfish.
  
  
• Please arrange to have someone drive you home the next day after the procedure.

• You will be awake during the procedure, but you will receive a medicine to relax.
  
  
• You may receive medicine (anesthesia) to numb the incision sites.
  
  
• The cardiologist makes a small incision in your groin or neck.
  
  
• He or she inserts a catheter through the catheter into a vein. The catheter is threaded through the vein up into the left atrium.
  
  
• To tell the size of the implant needed to close the hole, the cardiologist may:
  • inject a contrast dye. The dye will show the hole well on X-ray. You may feel a warm flush as the dye enters your body.
    
    
  • use a special ultrasound called a transesophageal echocardiogram. For this, the cardiologist will put a transducer (wand) down your esophagus (between your mouth and stomach). He or she can put the wand close to your heart and take pictures using sound waves.
    
    
• The cardiologist puts the right size implant into a special catheter. (The implant is collapsed so it will fit.)
   
  
• He or she threads the catheter to the site of the hole.
  
  
• The cardiologist expands the implant so it sets on each side of the hole. He or she releases the implant from the catheter and removes the catheter.

• You will be taken to a nursing unit to stay overnight.
  
  
• You may have some tenderness at the incision sites. (You will not feel the implant.)
  
  
• If you had a transesophageal echocardiogram, you may have a sore throat.
  
  
• You will be on bedrest for a while.
  
  
• You will be started on:
  • a blood thinner to prevent clots from forming on the implant
    
    
  • an antibiotic to prevent infection.
    
    
• You may receive some activity and lifting restrictions by your nurse or doctor.
  
  
• To care for your incision:
  • You may take a shower and wash with soap and water. Pat dry gently with a towel.
    
    
  • Avoid taking a bath, sitting in a hottub or going swimming for 2 to 3 days.
    
    
  • Please follow all instructions your nurse or doctor gives you.
    
    
  • Follow up with your doctor after you get home.

When to Call Your Doctor
Call your doctor if you have any of the following signs and symptoms:

• fever of more than 101 degrees Fahrenheit
• swelling, redness or bleeding at the incision sites
• numbness, tingling or weakness
• changes in your speech or vision.

• Home Care Following Angiography
• What to Expect: Your Heart Procedure at Minneapolis Heart Institute
• Preparation Instructions for Your Heart Procedure at Minneapolis Heart Institute
• Interventional Procedures: Questions & Answers

Other procedures for this sub-specialty

• Atherectomy
• Angiography (and Cardiac Catheterization)
• Coronary Stent Implantation
• Endomyocardial Biopsies
• IntraAortic Balloon
• Mitral Valvuloplasty and Aortic Valvuloplasty
• Peripheral Interventions