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Patent Foramen Ovale (PFO) / Atrial Septal Defect (ASD)

What is a(n):

  • Patent foramen ovale repair: also called a PFO closure, is a procedure that’s done to close the flap in the wall of the atrial septum.
  • Atril Septal Defect: An ASD repair, also called an ASD closure, is a procedure that’s done to close the opening in the wall of the atrial septum. 

Special considerations before your procedure:

  • If your procedure is scheduled in the morning, do not eat anything after 12 midnight the night before If your procedure is scheduled in the afternoon, you may have a light breakfast.
  • Take your routine medications with a sip of water.
  • If you are diabetic and take insulin in the morning, take ½ of your normal dose.
  • If you are are taking a diabetic medication called Glucovance/Glucophage®, stop taking this 
    drug______ days before your procedure unless otherwise directed by your physician.
  • If you are on a blood thinner such as Coumadin®, stop taking this drug ______days before your procedure unless otherwise directed by your physician.
  • If you are taking aspirin and/or Plavix®/Effient®,  continue unless otherwise directed by your physician.
  • If you are taking a diuretic (water pill), do not take it the day of your procedure, unless otherwise directed by your physician.
  • Bring all of your medicines with you in their original containers This includes over-the-counter and herbal medicines.
  • Bring your Bipap/Cpap machine if you have one.
  • Wear comfortable clothes.

What should I expect when I arrive?

  • You will check in with the receptionist at the Hanson Heart Center within Lakeland Medical Center in St. Joseph and be asked to fill out paperwork.
  • The nurse will take you to the prep area to review your health history and answer your questions. 
  • In the prep area you will sign consents, change into a gown, and have an IV started. The IV will allow us to give you fluids and medications as needed. 
  • You will be given an IV antibiotic to prevent infection.
  • You may also need lab tests done before the procedure.
  • It will be necessary to remove hair with electric clippers in the area of your groin where the catheter will be inserted.

What happens during the procedure?

  • You will be taken into one of our procedure rooms where you will be placed on the X-ray table.
  • You will be attached to equipment that will monitor your blood pressure, heart rate, and oxygen level. 
  • A nurse is present to give you medications to help you relax and to reduce any pain or discomfort you may experience. 
  • Your physician will insert a small flexible tube called a catheter into the vein of each of your legs to perform the procedure.
  • In addition, an intracardiac echo will be inserted to visualize the PFO/ASD and position the closure device.

What happens after the procedure?

  • Immediately after the procedure you will be taken to the recovery area. The catheter (sheath) will be removed from the groin and pressure will be applied by hand for 15 to 20 minutes until there is no bleeding. 
  • The insertion site will be covered with a pressure dressing. A five-pound sandbag will be applied to the site for a minimum of two hours. You will need to lie flat with your leg straight while the sandbag is in place. 
  • The nurse will frequently check your blood pressure, pulse, and the procedure site. 
  • If you are to be admitted overnight, you will spend a minimum of one to two hours in the recovery area of the Heart Center before being transferred to your room when it becomes
    available.
  • You will be given clear liquids to drink. Your diet will gradually return to normal as you are able to tolerate it.

When you go home:

  • You will need to have someone drive you home.
  • For the first 24 hours after your procedure, your activity will be restricted. You may be up for meals and to use the bathroom, otherwise you should lie flat or use a recliner to elevate your legs. 
  • Do not drive or operate machinery due to drowsiness from medication and/or potential for the groin site to bleed. 
  • Avoid bending over, squatting, and lifting over five pounds.
  • You will have a dressing on the procedure site. 
  • Keep this area clean and dry and change the dressing daily for five days. 
  • You should avoid using a hot tub, swimming, or taking a tub bath for five days after your procedure. However, you may take a shower.
  • Instructions concerning your medications, activity, and follow up care will be discussed in greater detail when you are discharged home. 

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