Doctor checks the heart for the patient

Patent Foramen Ovale Closure

A Patent Foramen Ovale (PFO) is a small hole between the left and right upper chambers of the heart. Everyone is born with this hole, but it typically closes on its own. A PFO exists when that hole doesn’t close naturally.  

According to the American Heart Association (AHA), about 25% of Americans have a PFO. Many people with a PFO never realize they have one and don’t have any associated health problems. For a small number of patients, a PFO can increase the risk of stroke, transient ischemic attack (TIA), and heart attack. According to the AHA, as many as half of patients who have had had a stroke of an unknown cause, or those who have had a stroke before age 55, have a PFO.  

A hole in the heart in and of itself does not cause a stroke. Rather, the hole provides an opening for blood to flow be-tween the right and left side chambers of the heart. Problems can arise when a blood clot travels across the hole to the brain and causes a stroke. 

Holes in the Heart
Learn more about PFO from the American Heart Association. 
patent foramen ovale (PFO)

Treatment options

Dr. Gilani helps to explain the diagnosis and treatment of patent foramen ovale (PFO).

Diagnosis, Treatment and Technologies


Specialized testing is needed to detect a PFO. This may include: 

  • Echocardiogram (echo): an ultrasound of the heart to check blood flow across the heart valves and chambers. 
  • Transesophageal echo (TEE): an ultrasound of the heart that provides information about size, structure and function. This allows physicians to see the overall health of your heart, including the function of your heart valves and chambers. 
  • Bubble study: done during an echo or TEE, an IV-filled with agitated saline is placed in your arm. The saline makes bubbles that are monitored to see if they move from one side of the heart to the other.


If treatment is needed, your cardiologist will consult with your neurologist on a plan. Possible treatment options may include: 

  • Blood thinning medication to prevent blood clots and stroke 
  • Device closure using cardiac catheterization
  • Minimally-invasive surgical repair, where the PFO is closed by placing a small device across the hole in the heart through the vein in the leg

A Total Repair of the Heart

Guy Pronesti, a PFO patient, shares the story of the hole in his heart.

Meet our

Patent Foramen Ovale Team

Our dedicated team of cardiologists.

Our Locations