ASD and PFO closure

ASD and PFO closure

When do ASDs and PFOs need to be closed?

ASDs usually need to be closed as they are associated with enlargement of the right side of the heart which can cause breathlessness if left untreated. PFOs are very common and most do not need to be closed. The usual reason to offer PFO closure is for patients who have had a stroke where we feel it is likely that it was caused by the PFO.

How do you close ASDs and PFOs?

Most can be treated with a minimally invasive procedure avoiding open heart surgery. The procedure is usually carried out as a day case, coming to hospital in the morning and generally going home the same day. There are various different types of closure device, but most look like two interconnected umbrellas that are opened on either side of the hole and then pulled together to seal it. The device is delivered through one of the veins in the groin. The procedure is carried out with x-ray and ultrasound guidance. The ultrasound guidance is either using a trans oesophageal echocardiogram, which is an ultrasound probe passed down the oesophagus into the stomach. This is done under general anaesthetic. The alternative is intracardiac echo, which is a small ultrasound probe that is advanced into the heart from 1 of the veins in the groin. This is generally done under local anaesthetic. At the beginning of the procedure we would generally do a confirmatory bubble study to confirm that there is a hole in the heart. We will then use a very soft balloon to determine the size and shape of the ASD or PFO. We can then select the appropriate sized device. The procedure takes around 30 minutes.

What are the risks of ASD or PFO closure?

The procedure is generally a low risk procedure and the chance of a serious complication is very small. We will discuss the specific risks that relate to you at the time of your consultation.

What experience does Dr Dawkins have of ASD and PFO closure?

Dr Dawkins runs the structural intervention programme in Oxford and is responsible for all PFO and ASD closure procedures in the region. He is frequently referred patients for a second opinion about PFO closure.

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    Dr Dawkins has private clinics in Oxford at the Nuffield Manor Hospital and in London at London Bridge Hospital. Please get in touch if you would like to make an appointment. We can usually arrange to see you within a few days. For urgent appointments, a same-day visit or telephone consultation can often be arranged. To arrange an appointment, please complete this form or call us on 020 7205 2024 (London) or 01865 598040 (Oxford).