Atrial Septal Defect (ASD) and Patent Foramen Ovale (PFO) Closure

Atrial Septal Defect (ASD) and Patent Foramen Ovale (PFO) closure are minimally invasive, catheter-based procedures used to seal an abnormal opening between the two upper chambers of the heart. These procedures are performed in the cardiac catheterization laboratory at Saint Francis Hospital through the Trinity Health Of New England Structural Heart Program.

What are ASD and PFO?

The heart has two upper chambers, the right and left atria, separated by a wall called the atrial septum. An Atrial Septal Defect (ASD) is a hole in this wall that has been present since birth, allowing blood to flow abnormally between the two chambers. Over time, an untreated ASD can enlarge the right side of the heart, cause shortness of breath, irregular heart rhythms, and increase the risk of stroke.

A Patent Foramen Ovale (PFO) is a small flap-like opening that is normally present before birth and usually closes shortly after. In about one in four adults, this opening does not fully seal. Most people with a PFO have no symptoms and need no treatment. In selected patients, however—particularly those who have had a stroke without another clear cause—closing the PFO can reduce the risk of another stroke.

How does ASD/PFO closure work?

The procedure is performed in the cardiac catheterization laboratory, usually under sedation or general anesthesia, and guided by X-ray and ultrasound imaging of the heart. A catheter is inserted into a vein in the groin and advanced to the heart. A small, self-expanding closure device is delivered through the catheter and positioned across the opening, sealing it from both sides. Over time, the body’s own tissue grows over the device, creating a permanent seal.

Most patients go home the day of the procedure or the next day and return to normal activities within a few days. Your care team will review medications, activity, and follow-up imaging before discharge.

Who is a candidate for ASD or PFO closure?

Candidacy is determined by the Heart Team after a complete evaluation. ASD closure is generally recommended for patients with a hemodynamically significant defect or related symptoms. PFO closure is considered in selected patients who have had a cryptogenic stroke (a stroke without an identified cause) and meet established criteria. Your interventional cardiologist will review the findings with you and your referring physician to determine the best treatment plan.

To learn more about ASD and PFO closure at Saint Francis Hospital, call 860-714-1265.