In most cases of asymptomatic PFO, treatment is unnecessary. In a small number of cases, however, intervention may be required to close the hole. Physicians may opt for either open-heart surgery or a catheter-based treatment. During the catheter-based treatment, a catheter is introduced into the body, usually through the groin, and guided all the way up into the heart. Once the catheter is in the correct position, the physician can measure the PFO and insert a device to plug the hole. There, it is used to close the PFO with a special plug. This procedure is called a transcatheter closure and is the most frequently used method of closing PFOs.

Because the shape and location of a PFO is often different than another defect in this region, the secundum atrial septal defect, there are now specialized devices specifically designed for closing PFOs.

In surgical closure, the procedure is performed in open-heart surgery. It is more invasive than device closure through a catheter. Some patients who are receiving surgery for another cardiac condition, such as a valve defect, may have a PFO closed at the same time. It is extremely unusual for open-heart surgery to be performed just for a PFO.

The recovery from PFO closure varies with the type of procedure and the general health of the patient. Patients may have some restrictions on physical activities for a few weeks following the procedure. In addition, patients may be placed on aspirin or anti-platelet drugs for six months or more after a closure device has been implanted. The treating physicians will provide detailed instructions following the procedure, including necessary follow-up visits and tests.

Early success has also been noted with robotically assisted surgery. Robotic surgery involves a voice-activated robot at the operating table and a cardiac surgeon in another room who manipulates hand controls that direct the robot where to cut and sew inside the chest. The surgeon directing the operation can view the procedure via an endoscope (a slim optical tube with an attached camera that is positioned inside the chest cavity). The advantage of using a robot is that the “hands” are smaller than human hands and require a much smaller incision. These techniques are reported to be safe and reliable, causing less pain to the patient, less surgical trauma and a shortened recovery time.