Introduction

What Is Atrial Septal Defect (ASD) Patent Foramen Ovale (PFO)?

Atrial septal defect (ASD) is a common congenital heart disease. It is caused by an abnormal opening between the left and right atrial septum, allowing blood to flow abnormally and increasing the burden on the heart.

The foramen ovale is a natural opening between the left and right atria that usually closes shortly after birth. If it remains open, it is known as patent foramen ovale (PFO). Many adults with PFO can live normal lives, but incomplete closure may increase the risk of blood clots and stroke.

Causes

Causes of Atrial Septal Defect/PFO

  • ● Congenital defect in the atrial septum (present from birth)
  • ● Incomplete closure of the foramen ovale after birth (patent foramen ovale, PFO)
Symptoms

Symptoms

Many patients with ASD or PFO may have no symptoms. When symptoms do occur, they can include:

  • ● Fatigue or reduced exercise tolerance
  • ● Shortness of breath, especially during exertion
  • ● Palpitations or irregular heartbeat
  • ● Stroke or transient ischemic attack (TIA) related to blood clots
Operation

The Occlusion Procedure

This procedure is performed in the Cardiac Catheterization and Interventional Laboratory (CCIL). The doctor will decide whether general anesthesia or monitored anesthesia is needed based on the patient’s condition.

Nurses will attach electrodes to monitor your heart rate and rhythm, and a blood oxygen monitor will be placed. Blood pressure will be measured periodically during the procedure.

After anesthesia, the doctor will perform transesophageal echocardiography (TEE) to assess the degree of septal defect or foramen ovale insufficiency and to guide the procedure.

A needle will be inserted into the femoral vein in the groin area to access the bloodstream. The doctor will advance a catheter into the heart to measure pressure in various chambers and calculate the degree of abnormal blood flow. Contrast dye may be injected for X-ray imaging.

A special balloon is used to measure the size of the septal defect, after which an occlusion device of appropriate size is implanted.

At the end of the procedure, the catheters will be removed. Depending on the wound condition, sutures and pressure may be applied to stop bleeding.

The procedure typically takes 2 to 3 hours. Patients will be closely monitored afterward.

Notice

Postoperative Care

  1. ● Like any invasive procedure, ASD/PFO occlusion carries risks such as bleeding, infection, allergic reactions, arrhythmias, and device-related complications. Your doctor will discuss these risks in comparison with other treatment options.
  2. ● After the procedure, please continue to take anticoagulant or antiplatelet medications as prescribed to prevent blood clots.
  3. ● Avoid strenuous exercise and heavy lifting for at least 7 days to allow proper wound healing.
  4. ● Keep the wound clean and dry. Change dressings immediately if they become wet, and watch for signs of infection such as redness, swelling, pain, or discharge. Seek medical attention promptly if any abnormalities occur.
  5. ● Generally, you may shower starting from the second day after surgery, but swimming or prolonged water exposure should be avoided for at least one week.

For further information, please consult your attending doctor or cardiologist. 

The above information is for reference only. As each patient’s condition may vary, please consult your doctor for individual assessment and advice.