Structural Heart and Valvular Disease Program: Patent Foramen Ovale and Atrial Septal Defect

Patent foramen ovale (PFO) and atrial septal defect (ASD) are congenital (present-at-birth) conditions of the heart. PFO occurs when there is a flap-like hole in the heart wall (septum). ASD occurs when there is a hole in the heart wall that separates the top two chambers of the heart.

PFOs are quite common, occurring in roughly one out of every four people. If no complications are experienced, treatment is usually not required.

However, roughly one out of every 100 babies are born with some type of heart defect, and ASD is the most common type. Some ASDs close on their own and require no treatment, while other ASDs will need treatment.

When treatment is needed, the cardiovascular specialists at the UF Health Cardiovascular Center can help. Our specialists, all faculty members of the University of Florida College of Medicine – Jacksonville, are experienced in treating and managing both of these complex conditions.

Video: Congenital Heart Defects


Symptoms of Patent Foramen Ovale

In most people who have this condition, there are no symptoms or complications that occur. When there are symptoms of PFO, they can include:

  • Transient ischemic attack (TIA), also known as a mini-stroke
  • Migraine headaches
  • Blood clots
  • Low oxygen levels

Your UF Health cardiologist can help you determine if these symptoms are related to PFO.

Diagnosing Patent Foramen Ovale

If your UF Health Jacksonville heart specialist suspects you may have a PFO that requires treatment, he or she may order an echocardiogram (echo) to obtain a detailed picture of the heart. Your doctor may also order what’s known as a “bubble test,” in which a saltwater solution is injected into the heart during the echo so your doctor can see whether the bubbles pass between the two chambers of the heart.

Treating Patent Foramen Ovale

If PFO is not causing any problems or symptoms, treatment probably won’t be required. In those with PFO who’ve had blood clots or strokes, surgery to close the hole may be needed. During the PFO closure procedure, your surgeon will make a small incision (generally in the groin) through which a catheter, a thin, flexible tube, is inserted. A closure device is inserted through the catheter and into the hole in the heart. The catheter is removed and then the incision will be stitched closed.

Medications are another way of managing PFO. Your cardiologist may prescribe blood thinning medication or anticoagulant (anti-clotting) medication to help reduce your risk of blood clots.


Symptoms of Atrial Septal Defect

Many people born with ASD may see the defect close on its own and not show any symptoms nor require treatment. However, symptoms may occur at almost any age, and can include:

  • Heart palpitations
  • Shortness of breath
  • Difficulty doing exercise or other physical activity
  • Swelling in the legs, feet or abdomen
  • Frequent lung infections
  • Heart murmur
  • Stroke

Diagnosing Atrial Septal Defect

If your heart specialist at UF Health Jacksonville suspects you may have ASD, one or more of the following tests may be ordered to aid in diagnosis:

  • Echocardiogram to obtain a video image of your heart to check the valves and look for signs of heart defects.
  • Chest X-ray to check your heart and lungs to help rule out other conditions that could be causing your symptoms.
  • Electrocardiogram to check the electrical activity of your heart for potential rhythm problems.
  • Cardiac catheterization to assess congenital heart defects, determine how well your heart is pumping blood and check how your heart valves are functioning.
  • Magnetic resonance imaging (MRI) to capture and analyze 3D images of your heart to check for structural or function problems.
  • Computed tomography (CT) scan to capture and analyze detailed images of your heart using X-ray.

Treating Atrial Septal Defect

In many cases, an ASD will close on its own during childhood. Other times, the defect may be so small that it doesn’t cause the person any problems, and therefore no treatment will be required. However, there are many cases in which surgery will be required to correct the ASD. There are two main types of surgical procedures to repair ASD:

  • Cardiac catheterization. In this procedure, your surgeon makes a small incision in your groin and inserts a catheter into your femoral artery. The catheter is threaded through your blood vessels and into the heart. Your surgeon then feeds a tiny mesh patch or plug through the catheter to close the hole in your heart. The heart tissue will then grow around the mesh, which permanently seals the hole.
  • Open-heart surgery. You’ll be put under general anesthesia for this procedure. Your surgeon will make an incision on your chest and use patches to close the hole. Depending on the type of ASD you have, the surgeon may be able to close your hole using minimally invasive surgery with small incisions.

Why Choose UF Health Treatment of PFO/ASD

The UF Health Cardiovascular Center – Jacksonville has internationally recognized physicians who are leaders in cardiac care, research and education Our doctors have been leaders in minimally invasive chest and heart surgery for more than two decades. Our cardiothoracic (heart and chest) surgeons are professors and researchers in one of the nation’s largest cardiothoracic training programs as part of the University of Florida College of Medicine – Jacksonville.

Our cardiologists, as faculty of the University of Florida Division of Cardiology – Jacksonville, participate in numerous national and international clinical trials. Using the most sophisticated equipment available, the center offers state-of-the-art diagnostic, therapeutic and rehabilitative cardiac services. Many leading-edge interventional therapies and more treatment options are offered in Northeast Florida only at the UF Health Cardiovascular Center – Jacksonville which in many cases means better outcomes for cardiovascular patients.