Thank you for choosing Rose Medical Center for your cardiac care. Our goal is to make your stay as comfortable and pleasant as possible. Please let our knowledgeable and friendly staff know if there is anything we can do to improve your experience.

What is a PFO/ASD Closure?

A PFO (patent foramen ovale) is a flap that is present when the atrial septum does not close properly at birth. An ASD (atrial septal defect) is a hole that is present in the septum between the atria that did not close at birth. A closure device is used to close the defect (hole). Over time your heart tissue will grow over the device and it will become part of your heart.

Why is this procedure being done?

This procedure is being done to close the hole in the septal wall between the right and left atria. Blood can flow from the right to the left atria or from the left to the right atria depending on the pressure in your atria. This is known as shunting. As a result from this shunting you are more at risk for:

  • Stroke
  • Right heart enlargement
  • Heart Rhythm disturbance
  • Pulmonary Hypertension
  • Leaking tricuspid and mitral valves
  • Shortness of breath

Before the Procedure:

You will be asked not to eat or drink anything after midnight the night before the procedure. Discuss your medications with your doctor, as he or she may want you to stop or adjust the doses several days prior to your procedure. Please bring all your current medications in their original bottles with you on the day of your procedure. Please bring a list of all drug/food allergies, past medical and surgical history also with you. We recommend that you wear comfortable clothing and bring a small bag with your personal items and toiletries in the event you spend the night in the hospital to make your stay as comfortable as possible.

What to Expect Upon Arrival to the Hospital:

When you arrive for your procedure, you will be asked to change into a gown. Please remove all undergarments and use the restroom as needed. Please let the staff know if you are taking blood thinners such as Aspirin, Coumadin, Plavix (clopidogrel), Effient (prasurgel), Brilinta (ticagrelor), Xarelto (rivaroxaban), Eliquis (apixaban), and Pradaxa (dabigatran etexilate), diuretics (water pills), and/or any form of diabetic medication. An IV will be started so you can receive medications during your procedure and the nurse will review your medical history with you once again. At this time blood work will be drawn if needed and an EKG will be performed.

During the Procedure:

The temperature in our catheterization lab is kept cool to prevent damage to the x-ray equipment that is used during your procedure. We will offer you warmed blankets for your comfort. You will be assisted on to a special table for the procedure and then we will begin attaching monitoring equipment to you.

The cardiac cath lab staff will shave and cleanse your groin while keeping your privacy as our primary concern. A sterile drape will be used to cover the site to prevent infection. It will be important for you to keep your arms and hands down at your sides during the procedure.

You will be given medications to help you relax, also known as twilight sedation, but you may be awake during the procedure so we can ask questions and assess your comfort. A local anesthetic will be given by the physician to numb the procedural site and aid in your comfort.

A catheter (long flexible tube) will be advanced to your heart and images will be taken. The closure device will be inserted into the catheter and guided to the defect by x-ray and intracardiac echo/ultrasound. The device will be advanced out of the catheter and opened up to cover the defect.

The average PFO/ASD closure may take 2 to 3 hours.

After the Procedure:

Your puncture site will be closed with manual pressure. A sterile dressing will be placed on the groin site to protect you from infection and the site will be observed for signs of bleeding frequently by your nurse for the next several hours.

You will be on bedrest for the next 2 to 6 hours where you will be asked to lie flat, keep the affected leg straight, and not to sit up or lift your head to help reduce your risk of bleeding. Should you have increased pain, numbness or tingling to your toes and feet, and a warm sensation like you have wet the bed, please call your nurse immediately.

Procedural Risks:

  • Allergic reactions to the medication
  • Bleeding
  • Heart attack
  • Stroke
  • Kidney damage
  • Infection
  • Bruising at the puncture site
  • Irregular heart rhythms
  • Blood clots
  • Damage to the vein wall where the catheter was inserted
  • Damage to the heart tissue

Contact Your Doctor If:

  • Fever greater than 101 and/or chills.
  • Redness, swelling, tenderness, and pus-like drainage from the puncture site.
  • You have problems taking or obtaining any of your heart medications.

Seek Care Immediately/Dial 911 If:

  • Chest pain and shortness of breath.
  • Bleeding or swelling from your groin site.
  • New and/or severe lower back pain (different from chronic back pain you may have.)
  • Coughing up blood.
  • Your leg below the puncture site changes color, becomes numb, or is cool to touch.
  • You have feelings of dizziness, extreme fatigue, or fainting spells.

Follow Up and Discharge Instructions:

  • Keep your dressing clean and dry for 24 hours after the procedure. After 24 hours, you may remove the dressing and shower normally. DO NOT sit in a hot tub, whirlpool, swimming pool, or bathtub for 7 days.
  • Refrain from using Band-Aids, powders, lotions or creams on the puncture site.
  • It is normal at the puncture site to have a small amount of bruising and some tenderness.
  • Wear comfortable and loose-fitting clothes for the first 3 days following the procedure.
  • Ask your doctor when it is safe to return to work and drive.
  • Ask your doctor when it safe to resume sexual activity.

Groin Puncture Site Care

  • Limit going up and down stairs to around twice a day for 5 to 7 days.
  • DO NOT lift, push, or pull heavy objects (more than 10 pounds) for the first 7 days.
  • If you need to cough, laugh, sneeze, or have a bowel movement, hold pressure on incision site. DO NOT strain or bear down.

References

If you have any further questions before your procedure please call the office and speak with your physician.

Thank You For Choosing Rose Medical Center For Your Cardiac Care!