Who is eligible for this procedure?
• ASD closure is indicated for patients with an evidence of enlargement of the heart due to blood leaking from the hole called ASD.
• PFO closure: In a patient presenting with a stroke (transient or permanent, mild or severe), causes of stroke such as narrowing of the carotid arteries and heart rhythm disorders are investigated. If these causes are excluded and there exists an opening called PFO in the heart, it is assumed that the cause of the stroke is probably small blood clots which first travel to the heart and then go through this hole and into the left side of the heart. Then, these clots may travel to the brain causing a stroke.
What is the success rate of the procedure?
It is >95%.
What are the risks of the procedure?
As with any interventional procedure, this procedure may also have risks which are very rare. For example, migration of the device or clot formation over the device occur in 1 out of every 100 patients. Death occurs in 1 out of every 1000 patients.
These risks made us anxious, what should we do?
You may be right to be anxious, but remember:
• These complications occur very rarely.
• What matters is whether the indication is correct. Avoiding this procedure, if decided in compliance with the guidelines, may imply that you in fact expose yourself to more serious risks (e.g., heart failure in case of ASD; stroke in case of PFO).
What tests are undertaken before the procedure?
Blood test: To check for other diseases such as anemia, kidney failure and infection.
EKG: To reveal whether there is a rhythm disorder in the heart.
ECO through the esophagus: To confirm the presence of the hole, to understand whether it is anatomically suitable for closure and to determine whether there is any additional heart disease.
How long does the process take?
Usually 1 hour. However, this period may be shorter or longer depending on the anatomical features of the hole.
Is the procedure performed by stopping the heart as in heart surgeries?
No. It is done while the heart is working.
Is there any pain during the procedure?
No. The procedure is performed either under sedation or under general anesthesia. The difference is this: In general anesthesia, a tube is inserted into the patient’s respiratory tract and the patient is given a respirator; In sedation, a breathing tube is not inserted, a respirator is not connected, the patient is only put to sleep, he breathes himself. In both techniques, drugs are given to prevent the patient from feeling pain throughout the procedure. If possible, sedation is preferred. Because with sedation, the procedure time is shorter and the risk is less.
How long is the hospital stay after the procedure?
Most patients are discharged the next day.
Is these devices of good quality?
These devices are produced by Abbott, Occlutech and Lifetech Scientific companies which are global manufacturers. All are of good quality and no significant superiority of one over the other is defined.
Does the device move?
No. Although cases that seem to have been displaced have been reported in the literature, this is a very rare situation.
Can I feel the device on my body after the procedure?
Will the device stay in the body lifelong?
Yes. But it doesn’t harm you.
Will I use blood thinners after the procedure?
Yes. In general, two blood thinners are used in combination for the first 2 to 3 months. One of them is low-dose Aspirin (Coraspin® or Ecopirin®), the other one is another drug with the active ingredient clopidogrel. All drugs are withdrawn after 6 months. As for PFO, blood thinner is continued indefinitely in most cases.