During fetal development, a small flap-like opening is normally present in the wall between the right and left upper chambers of the heart which normally closes during infancy. When the foramen ovale doesn't close, it's referred to as a patent foramen ovale. Most people with a PFO will not know they have it, because it's usually a hidden condition that will not show signs or symptoms.
An echocardiogram can be used to visualize the flow of blood from right atrium to the left atrium. A further test called "saline bubble study" is performed to confirm the presence of a PFO. In this study an agitated sterile saline solution is injected into the vein. In the presence of a PFO, the bubbles can be visualized in the left side of the heart. If no PFO is present, the bubbles are filtered out in the lungs.
Procedures to close the patent foramen ovale may be done in certain circumstances, such as to treat low blood oxygen levels linked to the patent foramen ovale. Physicians may recommend closure of the patent foramen ovale in individuals who have had recurrent strokes even after medical treatment.
Physicians can use a procedure called cardiac catheterization to insert a device that closes the patent foramen ovale. The physician will insert a long tube called a catheter into a vein in the groin and place it at the defect. A device is then inserted and pushed along the catheter and placed in the defect to close it. The procedure is done with the imaging assistance of an echocardiogram.
Although complications are uncommon with this procedure, a tear of the heart or blood vessels, dislodgement of the device, or the development of irregular heartbeats may occur.