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If you have a structural heart disease, you may not realize it since many do not show symptoms. Some structural heart conditions, such as holes in the heart, can lead to stroke. These conditions include atrial septal defect (ASD) and patent foramen ovale (PFO).
At the Center for Structural Heart Disease at Henry Ford Hospital, our heart specialists have deep expertise in minimally invasive procedures to treat PFOs and ASDs. Since 2012, we have performed well over 100 such procedures. We’re one of few heart centers in the country that performs these procedures.
This rare heart defect occurs in the septum, the wall between the heart’s 2 upper chambers (atria). During fetal development, if the septum does not develop properly, it leaves a hole. The hole allows oxygen-rich blood from the left atrium to leak into the right atrium, mixing with oxygen-depleted blood.
That means the mixed blood goes back into the lungs, forcing the heart to work harder to pump blood to the body. The additional blood flow can also cause fluid buildup in the lungs, which causes lung damage over time.
During fetal development, a fetus gets oxygen from the mother’s blood, not its lungs. So blood does not travel through the heart and lungs in a fetus the way it does in babies after birth.
In a fetus, an opening (foramen ovale) between the atria allows blood to flow through the heart, bypassing the lungs. When a baby is born and begins to breathe, the increased pressure in the heart causes the opening to naturally close. In 1 out of 4 people, however, the foramen ovale does not close.
A PFO is a common condition, but most people have no symptoms or complications unless they have another heart condition.
It’s normal for tiny blood clots to develop in the veins. Typically, the clots travel through the veins into the right atrium, through the right ventricle and into the lungs. There, capillaries (tiny blood vessels) in the lungs filter out the blood clots.
If you have an ASD or PFO, you may be at a higher risk for stroke. That’s because when tiny blood clots form in the veins and travel to the right atrium, the clots may go through the hole into the left atrium. From there, the blood clot passes through the left ventricle and the aorta into the body. The clot may travel through the arteries to the brain, where it can cause a stroke.
ASD is a congenital heart defect, meaning that people are born with it. Often, the exact cause of an ASD is not known.
PFO develops after birth, when the normal opening between the atria does not close as it should in the months after birth. The exact cause of PFOs is also unknown.
A PFO does not produce symptoms, unless you have another heart condition along with it.
If you have an ASD, you may not have symptoms until adulthood. The most common symptom of an ASD is a heart murmur (unusual sound during a heartbeat). Having a heart murmur does not necessarily mean that you have a heart problem.
If you have a large ASD that was not repaired during childhood, the excess blood flow on the right side of the heart can damage the heart and lungs. In adulthood, you may begin to experience signs and symptoms of heart failure, including:
When you come to Henry Ford, you may or may not already have a diagnosis. Either way, we begin our diagnostic process with a thorough evaluation. During your first visit, we meet with you to:
To help plan your treatment, our physicians may recommend further testing, depending on your symptoms and your previous test results. Learn more about the advanced testing we use for diagnosis.
After our comprehensive evaluation, our team of specialists meets to discuss your case. We work together to develop a customized treatment plan tailored to your needs.
If you have a small PFO or ASD, you probably don’t need to have the defect closed. You can see your physician for ongoing monitoring for any changes in your condition. We can also prescribe medications to help relieve any symptoms.
If you are experiencing symptoms of heart failure, we can perform a minimally invasive, catheter-based procedure to close the hole. We may recommend one or a combination of treatment options, depending on the severity of your symptoms and your overall health:
Our interventional cardiologists (specialists in catheter-based heart treatments) lead their field in minimally invasive procedures to treat structural heart disease. We have deep experience in transcatheter procedures that use a catheter (thin, flexible tube with micro instruments) inserted through a blood vessel to access the heart.
These techniques allow us to repair heart defects such as ASD and PFO without the need for open-heart surgery. Learn more about our other minimally invasive heart procedures.
With advanced 3D technology, we can create an exact replica of your heart anatomy. Using this model, we plan your treatment before the procedure begins. That means shorter, safer procedure times, less pain and a faster recovery. Find out how we use 3D imaging and printing in our treatment planning.
Although medications cannot cure structural heart problems, they can help relieve your symptoms so that you feel better. We can prescribe medications to manage your symptoms and lower the risk of complications. We can also help you make heart-healthy lifestyle changes such as healthy eating, physical activity and smoking cessation. Find out more about medication management.
At the Center for Structural Heart Disease at Henry Ford Hospital, our team focuses on providing the best possible outcomes for your health, with a compassionate touch. Learn more about what to expect through every step of your care journey.