Percutaneous PFO and ASD closure procedures are medical interventions employed to address congenital heart anomalies. These anomalies involve abnormal openings in the septum, the wall that separates the upper heart chambers (atria), potentially leading to complications. Closure procedures are recommended to mitigate associated risks.
- A Patent Foramen Ovale (PFO) is a persistent atrial septal opening present from birth.
- The primary aim is to prevent paradoxical embolism, a scenario where a venous blood clot can traverse the PFO and reach the brain, causing a stroke.
- It may also be considered for individuals experiencing migraines, as some evidence suggests a link between PFO and migraine headaches.
- An Atrial Septal Defect (ASD) represents a larger atrial septal opening enabling blood flow between the atria.
- Closure is performed to avert complications such as heart failure, pulmonary hypertension, and stroke.
- It becomes necessary when ASD is detected in infancy or childhood.
The patient is brought into a catheterization lab, receiving local anesthesia at the catheter insertion site, typically in the groin or arm.
A slender, flexible catheter is meticulously threaded through the chosen blood vessel, guided towards the heart. Some catheters have ultrasound capabilities for real-time cardiac imaging.
Employing imaging technologies like fluoroscopy or echocardiography, a cardiologist guides the catheter through blood vessels and into the right atrium.
Closure Device Placement
The catheter proceeds into the left atrium, targeting the PFO. A specialized closure device, often comprising metal alloy and mesh, is introduced through the catheter. It is positioned precisely to envelop and seal the PFO.
The cardiologist closely monitors the device's positioning using imaging techniques, ensuring effective closure without obstructing blood flow.
Upon confirming the device's optimal placement, effectively sealing the PFO, the cardiologist releases it from the catheter. The device remains permanently, and the catheter is then gently removed.
Local anesthesia is administered at the catheter insertion site, typically in the groin or arm.
The catheter is guided to the heart, first to the right atrium and then into the left atrium, where the ASD is located. Real-time imaging ensures precision.
Closure Device or Patch Placement
Inside the left atrium, a closure device or patch is introduced through the catheter. This device or patch is carefully positioned to cover and seal the ASD.
Monitoring and Confirmation
The cardiologist uses imaging techniques to monitor the closure device or patch's placement, confirming effective ASD closure. Once verified, the device or patch is released, closing the defect.
- Post-procedure monitoring in a recovery area.
- Pain management for any discomfort at the catheter insertion site.
- Administration of blood-thinning medications to prevent clot formation.
- Scheduled follow-up appointments with a cardiologist for ongoing assessment.
- Temporary restrictions on strenuous physical activity for a specified period, typically a few days to weeks.
- Patients are advised to promptly report any concerning symptoms or complications.