Patent Foramen Ovale Closure
(PFO)
Who is it for?
Your doctor will let you know whether you’re a good candidate for patent foramen ovale (PFO) closure with a PFO occluder device. If you have a PFO and have suffered a cryptogenic stroke (meaning it’s not attributed to a cause such as atrial fibrillation (Afib), carotid artery disease, etc.), then device closure of your PFO may be an excellent option for you. However, it’s essential to remember that about 800,000 strokes occur per year in the U.S.—87% of which are ischemic strokes1—and that many of these do have identifiable causes.
You also may be a good candidate for this procedure if these additional criteria are met:
- If it’s been determined that you are at a high risk for a second stroke (there are some risk calculator tools your doctor can use such as the RoPE Score)
- If long-term treatment with anticoagulant medications is deemed not a good option for you in a shared decision between you and your doctor
- If you have another condition besides stroke that could benefit from a PFO closure such as a problem with low blood oxygen levels and consequent breathing difficulty (also known as orthodeoxia-platypnea and often caused by the movement of blood through the heart before it can be adequately oxygenated), decompression sickness in divers, or other unexplained arterial embolic events. These conditions all require an individual evaluation and discussion of treatment options with your doctor.
Who shouldn’t consider PFO closure?
While PFO closure has been generally found to be very beneficial, it may not be for everyone. Some people may not be good candidates for PFO closure for one or more of the following reasons:
- They have other conditions that will explain the stroke such as significant Afib or carotid artery disease.
- Their work-up identifies certain congenital irregularities or unexpected pathologies such as tumors or clots that would preclude them from having the procedure.
- They have a nickel allergy. Although this isn’t an absolute contraindication to having a PFO closure, it requires careful discussion of risks versus benefits as well as device choice.