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What Is the Foramen Ovale?

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  • Written By: Tricia Ellis-Christensen
  • Edited By: O. Wallace
  • Last Modified Date: 21 August 2014
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It’s commonly stated that some children born with heart defects have a hole in the heart. Actually, just about everybody is born with a hole in the heart, called a foramen ovale. This is a communication between right and left atria that does not close before birth in most cases. It can take a few months to a few years for the communication to close, and in some people, it remains open. This condition is called a patent foramen ovale, and could require medical intervention, though not always.

There is an important distinction to be made between foramen ovale and another condition present at birth called patent ductus arteriosus. The ductus is an additional communication between the aortic and pulmonary valves that allows for blood to circulate appropriately in the fetal body. Like the foramen ovale, the ductus tends to close on its own, though this typically takes less time and may occur within a few hours of birth. The ductus may remain open, too, causing problems that might necessitate its treatment. Of these two conditions, presence of patent foramen ovale is thought to be much less of a danger.

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A patent foramen ovale is not without risks. First, it causes the body to mix blood. Some unoxygenated blood migrates back from the right atrium to the left atrium, and this means blood may have a slightly lower oxygen content. Allowing the foramen ovale to remain open also increases the possibility of stroke. To this end, many cardiologists recommend people with this condition use blood thinners.

As stated, a number of people receive minimal or no treatment for patent foramen ovale, but there may be some circumstances where closure of the atrial communication is desired. First, if people undergo heart surgery for other reasons, particularly to fix other congenital heart defects, closure could be recommended. Ironically, it’s often this defect that makes life sustainable until other defects can be repaired.

Some people without other defects or heart problems will suffer symptoms from this condition include tiredness, fatigue or low oxygen saturation levels. If these symptoms seriously interfere with life or activity, closure could be considered. It might also be weighed as a possible option if strokes have occurred or if a person suffers from serious migraines.

Closure doesn’t necessarily mean invasive heart surgery. Many times, the atrial communication is closed during a catheterization, using seals or devices that keep it shut. Open-heart closure might take place only if deemed necessary or if other heart defects are being repaired. Surgeries or cath closures are typically very successful, but again they are not recommended for all people, unless health deterioration or present health risk is clearly established.

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