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

Call for more information: 770-219-5416

Revolutionizing Treatment for Congenital Abnormalities in the Heart

It would seem that a hole in the heart is always serious. But a large percentage of the one-quarter of Americans who have one experience no symptoms. For those that do, The Heart Center of Northeast Georgia Medical Center (NGMC) offers treatment options, including a minimally-invasive repair procedure.

There are two types of holes in the heart: atrial septal defect (ASD) and patent foramen ovale (PFO). Both are holes in the wall of tissue between the left and right upper chambers of the heart, called the septum.

The causes of the two conditions are very different. Patients are born with ASDs, which occur when the septal tissue doesn’t form correctly between the two chambers. ASD holes can vary in size and the severity of abnormal blood flow often correlates with the size of hole.

PFOs, on the other hand, are a remnant of an important function before birth. The foramen ovale is a hole between the two chambers of every growing baby’s heart. The hole has a purpose—it allows blood to bypass the lungs while the baby is in utero since the lungs aren’t functional and blood arrives at the heart already oxygenated by the placenta. There is a flap of tissue that is held open by flow and when the baby is born and the pressures through the hole drop as blood is redistributed to the lungs, the flap closes. The foramen ovale completely seals shut in approximately 75 percent of people within several months after birth. When it retains some ability to reopen in certain circumstances, it’s called a PFO.

Some patients with a hole in their heart won’t experience symptoms; but for others, the conditions can negatively impact their quality of life.

“PFO and ASD are variations of a congenital abnormality that result in abnormal communication between the upper chambers of the heart,” says Chris Leach, MD, FACC, FSCAI, interventional cardiologist at The Heart Center of NGMC.  “A percentage of these patients may have an increased risk of stroke.  ASDs can also result in abnormal blood flow through the heart, eventually leading to heart failure.”

What’s the Connection Between a Hole in the Heart and Stroke?

Many strokes are caused by blood clots that clog the arteries in the brain and cut off blood flow. In those with PFOs, small blood clots that would normally be absorbed by the lungs can flow through the hole, carrying out into the body. If even a very small clot makes its way to the brain, it could lead to a stroke. According to the American Stroke Association, approximately 100,000 Americans suffer a PFO-related stroke each year.

Surveying the Treatment Options

In many cases, holes in the heart require no treatment. Until recently, for those that did experience symptoms, treatment options were limited to blood thinning medications. Today, however, a minimally-invasive closure procedure allows interventional cardiologists to repair the defect with limited side effects.

“In the past, the only treatment was lifelong blood thinners for those with strokes or an open-heart repair of the hole for ASDs,” said Dr. Leach. “This newer procedure can reduce the risk of recurrent strokes similar to blood thinners, but without the bleeding risk. During the procedure, we enter the body through a 1/8-inch incision into a vein about the level of the hip rather than through a much larger chest incision. Because of this, the patient is usually up and walking a couple hours after the procedure and goes home the next day with few limitations on normal activities.”

The minimally-invasive defect repair provides a number of benefits for patients, including:

  • No significant blood loss
  • No visible scars
  • Reduced morbidity
  • Short bed rest after procedure

Who’s a Candidate?

“Certain types of patients benefit most from this procedure,” Dr. Leach said. “This includes young people who’ve had strokes without other obvious causes and those who have ASDs with proper anatomy. The procedure allows us to prevent worsening right heart function and possible congestive heart failure.”

To request an appointment with a cardiologist at The Heart Center of NGMC, call 770-534-2020 or visit heartngmc.org/appointment.  

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