Chat with Cleveland Clinic Physicians for Health Information

I had a PFO closed a few months ago. I still have symptoms. The doctor said they are evaluating me to see if he needs to go back for more surgery. Is that common for the closure to not be complete? Should I go somewhere else or go back to my surgeon? What are the chances of success the second time?

Fri, 28 Nov 2008 10:52:42 -0500

Patent foramen ovale (PFO) closure is a fairly controversial topic at this time. In general, experts agree that patients with recurring stroke on medical therapy with PFO ought to be considered for closure - surgical or percutaneous.

Percutaneous closure is successful in excess of 95 percent of the time. Occasionally we see a small residual shunt. This can often be approached through another percutaneous procedure. Each case, such as this, needs to be fully assessed before making such a decision.

If I had a VSD when I was younger repaired - how likely are my kids to have the same thing?

Fri, 28 Nov 2008 10:54:06 -0500

A recent paper found that children of patients with congenital heart defects have approximately a 3 percent risk of having congenital heart defects, which are not infrequently different lesions. This is higher than the reported 0.8 percent risk of congenital heart disease in the general population.

Your obstetrician should be aware of your heart defect and your child should be appropriately screened after they are born.

I have been followed for a VSD since I was an infant. During my last echo, the doctor stated my vsd had gotten larger and I have a small septal aneurysm near the vsd. He wants to watch me still but bring me back in a few months rather than a year. What are the indications for surgery - what is he waiting for?

Fri, 28 Nov 2008 10:56:13 -0500

Surgery should certainly be considered in the presence of any known complications of VSD, such as right heart enlargement, heart failure, pulmonary hypertension, or arrhythmias. We still base our decisions for surgery on these symptoms or by quantification of the amount of shunt flow(blood flowing across the defect), which can be assessed by echocardiography or preferably MRI.