The foramen ovale is a flap-like opening in the wall that separates the two upper chambers of the heart. Before birth, the foramen ovale allows a circulatory bypass of the lungs, which the baby is not yet using. Normally, the foramen ovale closes shortly after birth. Patent foramen ovale describes the condition wherein the foramen ovale remains open. Treatment for patent foramen ovale is needed only if the condition causes complications.
Anticoagulant Medication
Patent foramen ovale is a common condition. The Cleveland Clinic reports approximately 25 percent of the population have patent foramen ovale, most without symptoms or complications. However, patent foramen ovale has been linked to ischemic strokes in some people. An ischemic stroke occurs when blockage in an artery halts blood supply to a circumscribed area of the brain. As noted by the Cleveland Clinic, 40 percent of people without an unidentifiable cause of ischemic stroke have a patent foramen ovale. Physicians believe some of these strokes may be caused by small blood clots that pass through a patent foramen ovale and reach the brain. Medical treatment is an option to prevent future strokes among those with an unexplained ischemic stroke and a patent foramen ovale. Doctors may prescribe anticoagulant medications, also known as blood thinners, to decrease the risk of blood clots. Medication options include aspirin, warfarin and clopidogrel.
Percutaneous Closure
Percutaneous closure of a patent foramen ovale is a treatment option for those with, or at high risk for, complications associated with this condition. The term "percutaneous" means through the skin. The Mayo Clinic explains that a percutaneous closure of a patent foramen ovale is accomplished by inserting a device into a blood vessel in the groin and threading it up into the heart. Through tiny instruments at the end of the device, a plug is placed into the patent foramen ovale to seal the opening. Percutaneous patent foramen ovale closure may be advised for those who are unable to take anticoagulant medications.
Surgical Closure
In cases of an especially large patent foramen ovale, or if other structural heart defects are present along with this condition, surgical closure may be advised. The Cleveland Clinic explains that surgery may involve opening the chest to expose the heart. Alternatively, some surgical centers perform the procedure with robotic assistance through a small incision in the chest. The advantages of a robotically-assisted surgical repair include shorter recovery time, less intraoperative bleeding, and decreased infection risk.
References
- Cleveland Clinic: Patent Foramen Ovale
- Mayo Clinic: Patent Foramen Ovale, Treatments and Drugs
- University of Maryland Medical Center: Patent Foramen Ovale
- Cleveland Clinic: Robotically Assisted Heart Surgery: Patent Foramen Ovale (PFO): New Approaches to Minimally Invasive Heart Surgery
- Medline Plus: Patent Foramen Ovale
