Information from Theresa M. Brennan, MD:
All of us have patent foramen ovales (PFOs) before birth. These are small, flap-like openings in the dividing wall (septum) between the heart's two upper chambers. The flap-like opening usually fuses after birth.
However, in a surprising number of us—15 to 20 percent—the foramen remains open or "patent." Problems rarely occur and most people with PFOs that don't close don't know they have one. In some people, however, this opening might allow a clot to enter the arteries that supply blood to the brain and cause a stroke or transient ischemic attack.
Until recently, the only alternative to medication for preventing TIA or stroke in persons with PFO was open heart surgery. Today, these people may benefit from a non-surgical method using a device called a PFO closure device.
In 2006, one of my colleagues, Harold Adams, MD, a nationally known stroke expert at UI Hospitals and Clinics, studied a way to help prevent strokes in patients with a PFO. During the procedure, an implant is placed in the heart using a catheter. Patients are awake for the entire procedure and able to watch the proceedings on a monitor.
It's interesting to note that the Iowa study involved pediatric cardiologists with UI Children's Hospital. Holes within the heart are more commonly identified in children than adults, so pediatric cardiologists usually have the most experience with actual treatment of patients with these types of holes.