PFO (Patent Foramen Ovale) Closure: A PFO is a tunnel between the right and left atrial chambers of the heart. This is leftover from fetal life and can cause strokes or “mini strokes” (TIA). Closing the tunnel involves making a small incision in the right femoral vein and inserting a catheter into the heart. The device catheter is guided by ICE (intracardiac echo) and low level radiation called fluoroscopy. The device catheter is then placed between the two atrial chambers and the “umbrella-like” (two-sided) device is opened on the left side. The left side of the PFO is closed and then the right side of the device is opened to “pinch” together the two pieces of the tunnel, blocking flow from crossing over from the right to the left side. This is an outpatient procedure.

 ASD (Atrial Septal Defect) Closure: An ASD is a direct communication or a “hole” between the right and the left atrial chambers. This is a congenital heart defect and once discovered, should be closed. The defect is closed by using the Amplatxer ASD occulunder device. This procedure is performed by catheterization similar to the PFO closure and involves “pluggin” the hole with the ASD device. Patients must have transesophageal echocardiography prior to the ASD closure because it must be determined that the device will be able to sit between the rim of the ASD. There is a cardiac surgeon to discuss surgical closure of the defect.

 Carotid Angiography/Stent: This is a procedure which diagnoses and repairs blocked vessels in the carotid arteries, the large arteries on each side of the neck. A catheter is placed in the femoral artery and passed into the carotid circulation. A contrast “dye” will be injected into the catheter which will indicate the area of occlusion or narrowing/blockage of the carotid arteries. Each side of the head and neck is done at the time of the angiogram. If the carotid arteries are blocked or narrowed and a stent is required, the procedure will be scheduled for a later date. If both arteries are in need of stenting, these will be done separately and on different dates.