Patent Foramen Ovale

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There is a hole in the wall between the two upper chambers of the fetal heart in the womb. This hole, called the foramen ovale, is a normal part of the fetal heart anatomy and usually closes after birth. Patent foramen ovale (PFO) is a condition in which this hole doesn’t fully close, which allows blood from one upper heart chamber to leak into the other upper chamber.

A PFO doesn’t cause any health problems on its own; however, other conditions may be affected if you also have a PFO. Particularly, a PFO may allow small blood clots that would normally be filtered out by the lungs to instead remain in circulation and reach the brain, causing a stroke. About 50 percent of people with strokes without other known causes also have a PFO.

The reasons why a foramen ovale may not close are unclear. Genetics may be a factor.

Are You at Risk for a PFO?

The foramen ovale is part of normal fetal development, so everyone has one in the womb.

About 25 percent of people have a PFO. These usually remain undetected, however, because most people with PFOs do not experience any related health problems.

Diagnosing PFO

At UVA, we detect PFOs using an echocardiogram with a saline contrast study (also called a bubble study). Using the saline contrast study, cardiologists can see whether tiny bubbles in the blood passing through the right upper chamber of the heart appear in the left upper chamber.

Treatment for a PFO

Most PFOs go undetected and do not require any treatment.

When necessary, people with PFOs have traditionally been treated with life-long blood thinners to reduce the possibility of developing clots that could cause a stroke.

At UVA, stroke patients with PFOs also have the option to undergo a minimally invasive procedure that patches the hole using a catheter. The patch forms a foundation for the heart to deposit heart muscle cells around it, sealing the PFO and preventing blood from leaking through.

Understanding PFO

Scott Lim, MD is a cardiologist at UVA Health System. Dr. Lim discusses Patent Foramen Ovale, or PFO, a hole in the heart that is a common cause for stroke. PFO Closure provides a minimally invasive treatment option for patients. View Transcript.