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Cardiology · UK

Patent foramen ovale closure - a keyhole fix, through a leg vein.

A small device, delivered by catheter, seals the flap between the heart’s upper chambers in under an hour - no chest incision, usually home the same day. A structural cardiologist, proper imaging first, and an honest view on whether you need it at all.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What private PFO closure costs in the UK.

Indicative package ranges across our partner cardiac units.

In short

£9,500–£14,500, home same day or one night.

Procedure Indicative range
Percutaneous PFO closure (device, all fees) £9,500–£14,500
Transoesophageal echocardiogram (TOE) £800–£1,500
Bubble-contrast transthoracic echo £350–£650
Follow-up bubble echo (post-closure) £300–£600
Structural cardiology consultation only £250–£400

Prices vary by hospital, by the cardiologist, and by the device chosen - the occluder itself is a significant part of the cost. NHS closure is commissioned for qualifying stroke cases; where you meet those criteria we tell you plainly.

The problem

A common finding, an uncommon procedure - matched carefully.

One adult in four has a PFO. Very few need it closed. The craft is in selecting the right patients, the right device, and the right operator.

  • Is the PFO really the culprit?

    Before any device is considered, the work-up must rule out the ordinary causes - AF, carotid disease, clotting disorders. That is a neurology conversation as much as a cardiology one.

  • The imaging decides the device

    Tunnel length, rims and any septal aneurysm on TOE determine which occluder fits your anatomy - not which one the catalogue prefers.

  • Volume matters in the lab

    Complication rates for structural procedures track operator volume.

When it helps

When PFO closure is the right step.

The situations we see most, plus the one red flag that means 999 rather than any kind of booking.

  • Cryptogenic stroke under 60

    A stroke with no other cause found, a PFO on bubble echo, and a joint cardiology–neurology view that the two are connected - the core indication.

  • TIA with a significant shunt

    A transient ischaemic attack with a large right-to-left shunt, especially with an atrial septal aneurysm, after full work-up.

  • Recurrent events on medication

    A further stroke or TIA despite well-taken antiplatelet or anticoagulant therapy strengthens the case for mechanical closure.

  • Decompression illness in divers

    Divers with unexplained or recurrent decompression sickness and a significant PFO - closure can allow a safe return to diving.

  • Platypnoea–orthodeoxia syndrome

    The rare situation where sitting up drops your oxygen levels because blood shunts across the foramen - closure is curative.

  • Migraine with aura - selected cases only

    The evidence is mixed and closure is not routinely recommended for migraine alone. We give you the honest version of that conversation.

  • Occupational need

    Commercial divers, pilots and others whose licensing depends on eliminating a documented shunt after a qualifying event.

  • Red flag: stroke symptoms now

    Face drooping, arm weakness or speech trouble right now is a 999 call and an emergency stroke unit - never a private booking.

Procedure options

One goal, several routes - chosen on your anatomy.

Device family, imaging guidance and anaesthetic approach all flex to the tunnel the TOE shows - and sometimes the right option is no device at all.

  • Percutaneous device closure

    The standard of care. A catheter from the groin vein delivers a self-expanding double-disc device that sandwiches the septum and seals the tunnel. No chest incision.

  • Amplatzer-type occluders

    The most widely used family of nitinol double-disc devices, with the longest follow-up data. Sized to the anatomy seen on TOE.

  • Gore septal occluder

    A soft, conformable ePTFE-covered device that suits longer tunnels and atrial septal aneurysms. Choice of device is the operator’s call, made on your imaging.

  • Suture-based closure

    A newer deviceless technique that stitches the foramen closed, leaving no permanent implant - available in selected UK centres for suitable anatomy.

  • Echo guidance: TOE or ICE

    The device is placed under transoesophageal echo (with sedation or brief general anaesthetic) or intracardiac echo from a second groin catheter under local anaesthetic alone.

  • Medical therapy instead

    Antiplatelet therapy without closure remains a respectable option, particularly over 60 or where the PFO is likely incidental. We lay out both routes honestly.

  • Surgical closure

    Open or keyhole surgical closure is now rare - reserved for PFOs found during heart surgery being done for another reason.

  • ASD closure - a different procedure

    A true atrial septal defect is a hole with flow in both directions, needing different devices and follow-up. TOE tells the two apart before anything is booked.

Safety and recovery

What to expect afterwards - honestly.

PFO closure is one of the safer procedures in cardiology, with serious complications well under 1 percent in experienced units. Here is the honest picture.

  • A short procedure, usually awake

    Most closures are done under local anaesthetic with sedation in 45–60 minutes, through a single puncture in the groin vein. Many patients go home the same evening.

  • Atrial fibrillation afterwards

    The most common complication - short-lived palpitations or AF in roughly 2–5 percent of patients in the weeks after closure. It usually settles; occasionally it needs treatment.

  • Groin puncture problems

    Bruising is common and harmless. Significant bleeding, haematoma or vessel injury occurs in under 1 percent. Keep the leg straight for the hours the team advises.

  • Device-related events - rare

    Device embolisation, clot on the device, erosion or significant residual shunt are each well under 1 percent in experienced hands, which is why operator volume is a selection criterion.

  • Antiplatelets for months, not days

    Aspirin and clopidogrel typically run for 1–3 months while the device endothelialises, then aspirin alone. Dental antibiotic-prophylaxis advice applies for the first six months.

  • Residual shunt

    A small residual leak on the follow-up bubble echo is seen in a few percent and usually closes over the first year as tissue grows over the discs.

  • Nickel allergy

    Most devices are nitinol (nickel-titanium). True reactions are rare; tell the team about any nickel sensitivity so device choice can reflect it.

  • Normal life resumes quickly

    Desk work within a day or two, driving after a few days, gym after a week or two, flying typically after a week. Diving only after the follow-up echo confirms closure.

  • Red flags after the procedure

    Chest pain, breathlessness, palpitations that will not settle, a swelling or thrill in the groin, or any stroke symptoms need the same-day team or A&E.

Reading your procedure note

Your procedure note in four parts. Read the last one first.

Whichever device was used, the note the cardiologist sends you keeps to the same shape.

A UK consultant cardiologist reviewing a patient’s procedure notes

A quiet reminder

Catheter-lab language is precise and can read coldly - we translate it for you.

If you would like us to talk you through the procedure note and the echo images before your review, just ask.

  1. 01 Header

    Indication and anatomy

    Why the closure was done, the tunnel length and any atrial septal aneurysm, and the shunt grade on your pre-procedure bubble study.

  2. 02 Technique

    Access, imaging and device

    The venous access, whether TOE or intracardiac echo guided the deployment, the device make and size, and how many attempts positioning took.

  3. 03 Findings

    Result on the table

    The final echo appearance - disc position, capture of the rims, and whether any residual shunt was visible before the catheters came out.

  4. 04 Impression

    Drugs, follow-up and clearances

    Read this first: your antiplatelet regime and its stop dates, the follow-up bubble echo date, and when diving, flying or heavy training are cleared.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

PFO closure after a qualifying stroke or TIA is usually covered when medically indicated; closure for diving or migraine often is not.

Frequently asked

Everything we get asked about PFO closure.

Quick answers on the procedure, eligibility, recovery, cost and NHS availability.

  • What actually is a patent foramen ovale?

    The foramen ovale is a flap valve between the two upper chambers of the heart that every baby needs before birth. In about three-quarters of people it seals in infancy; in the remaining quarter it stays potentially open - patent. For most of those people it never matters. It becomes relevant only when clot or bubbles can cross it from the right side of the heart to the left.

  • How is a PFO closed?

    Through a vein at the top of the leg, under local anaesthetic with sedation or a short general anaesthetic. A catheter carries a folded double-disc device to the heart, one disc opens on each side of the septum, and the foramen is sandwiched shut. The procedure typically takes 45–60 minutes and most people go home the same day or the next morning.

  • Does having a PFO mean I need it closed?

    No - around one in four adults has one, and the vast majority need nothing at all. Closure is recommended mainly for people under about 60 who have had a cryptogenic stroke or TIA attributed to the PFO after a proper joint cardiology–neurology review, and for selected divers with decompression illness. An incidental PFO found on a scan is usually left alone.

  • How much does private PFO closure cost in the UK?

    A typical all-inclusive package - device, catheter lab, cardiologist, anaesthetist and one night’s stay - runs at roughly £9,500–£14,500. The transoesophageal echo beforehand adds £800–£1,500 and the follow-up bubble echo £300–£600 if not bundled.

  • What is recovery like?

    Gentler than most people expect. A few hours lying flat to protect the groin, home the same day or next morning, desk work within a couple of days and normal exercise within one to two weeks. The main commitments are the antiplatelet tablets for a few months and the follow-up bubble echo at one to three months to confirm the shunt has sealed.

  • Is PFO closure available on the NHS?

    Yes - NHS England commissions PFO closure for patients up to 60 with a cryptogenic stroke attributed to the PFO, through specialist centres, and NICE supports the procedure. Waiting times vary by region. Going privately buys speed, choice of operator and continuity; the clinical criteria we apply are the same either way.

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