Closure of Atrial Septal Defect and Patent Foramen Ovale

Atrial septal defects (ASD) and patent foramen ovale (PFO) are intracardiac defects, or "holes in the heart". They are abnormal openings in the wall (septum) that separates the two atria, or upper chambers, of the heart. PFO result when a normal opening in the septum fails to close after birth, while ASD are caused by abnormal development of the septum. ASD are usually larger than PFO, and are divided into several categories, depending on their location. Those of the secundum type, for example, occur near the middle of the wall. PFO and small ASD can cause strokes by allowing clots and air to enter the left side of the heart, while larger ASD can cause heart failure and an abnormal increase in the blood pressure in the lungs, called pulmonary hypertension.

Closure of these types of defects can be accomplished using open-heart surgery. At NewYork-Presbyterian Hospital, we offer two less invasive ways to repair these defects. Our interventional cardiologists offer a catheter-based approach for repair of secundum type atrial septal defects and patent foramen ovale, in which a catheter is inserted into a blood vessel in the groin and is guided to the heart, where it is used to deliver a tiny umbrella-shaped "patch" that is inserted into the opening. This approach avoids surgery and use of the heart-lung machine. The procedure only requires an overnight stay in the hospital; patients can return to work within a day or two.

In addition, our surgeons offer a minimally invasive approach, in which the defects are closed directly while avoiding a large chest incision. This procedure is done through small incisions between the ribs, is associated with hospital stays of 3-5 days, and can close very large or complex defects that are not appropriate for catheter closure.

Last modified: 12-1-2009