Patent Foramen Ovale (PFO) Closure

A patent foramen ovale (PFO) closure is a procedure to close a small hole in the heart that exists during fetal development to promote blood flow and, in the majority of cases, either closes on its own during infancy or remains open but never causes problems. A small flap-like opening, the foramen ovale is located in the wall between the two upper chambers of the heart.  In about one out of four people, the hole does not close on its own, but fewer than 1 percent of people ever need to have a PFO closed.

Closure may be recommended if the PFO is suspected to be causing otherwise unexplained strokes, transient ischemic attacks (TIAs, or “mini strokes”), or embolisms (bloodstream blockages). Closure involves a small incision usually made in the inner thigh area, through which a catheter holding a closure device is inserted into a large vein and slowly guided into the heart. Once the catheter reaches the PFO, the device is released and allowed to expand into the intended shape necessary to seal the hole. The catheter is then removed, but the closure device remains as a permanent implant. The procedure typically is followed by a chest X-ray and/or an echocardiogram to confirm that the device is properly positioned. 


The UAB Congenital Heart Disease Program offers the most advanced care for structural heart disease, which often requires lifetime monitoring and care. Our multidisciplinary team of pediatric and adult cardiologists, cardiovascular surgeons, cardiovascular anesthesiologists, and maternal/fetal medicine specialists are uniquely qualified to treat patients before birth and into adulthood. In addition to seeing patients at the UAB Women & Infants Center and The Kirklin Clinic of UAB Hospital, UAB Medicine’s congenital heart disease specialists also see patients at North Alabama Children's Specialists in Huntsville and Physicians to Children/Central Alabama Children's Specialists in Montgomery.

Our modern ultrasound equipment allows many heart defects to be diagnosed before a child is born. Screening exams performed at 18-20 weeks are recommended for expectant mothers (or fathers) known to have congenital heart disease. If a defect is discovered, prenatal treatment and planning for delivery and postnatal treatment can be undertaken.

Thanks to advances in pediatric congenital care, the life expectancy for most patients now reaches far into adulthood, but more than 60% stop seeing a cardiologist once they turn 18. UAB’s Alabama Adult Congenital Heart Disease Program is designed to prevent that gap in care. As the only adult congenital heart disease program in the state and one of only a handful in the country, our expertise greatly increases the chances that symptoms will be identified early. This helps ensure that smaller problems are addressed before they develop into larger, more life-threatening issues such as heart failure, arrhythmia, residual congenital heart defects, endocarditis, and stroke.



Related Conditions

This procedure may be used to treat or diagnose several different conditions. We have listed some of these conditions below for your convenience. Please note that this is not a comprehensive list and may vary depending on your specific diagnosis.


Patent Foramen Ovale

A patent foramen ovale is a small hole in the heart that does not close the way it should after birth. During a baby's development, the foramen ovale, a small flap-like opening, is located in the atrial septum between the right and left upper chambers of the heart. It allows blood to go around the lungs during fetal circulation to speed up the travel of blood through the heart. It normally closes during infancy, but if it does not it is called a patent foramen ovale, or PFO. In about one out of four people, the hole does not close. Most people do not even know they have the condition until it is discovered during tests or while seeking treatment for other problems, such as a stroke.

PFOs usually cause no symptoms, and less than 1 percent of people ever need to have a PFO closed. Having a PFO may be upsetting, but most never need treatment. The cause of a PFO is unknown, and there are no known risk factors. Infants with a PFO but no other heart abnormalities should enjoy normal health.