When does the foramen ovale close?

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From the Research

The foramen ovale typically closes shortly after birth, with most cases completing closure by 3 months of age, although in about 25% of the general population, it remains partially open throughout life, a condition known as patent foramen ovale (PFO) 1. The closure process begins when the baby takes its first breath after birth, which increases pressure in the left atrium while decreasing pressure in the right atrium. This pressure change causes the septum primum to press against the septum secundum, eventually leading to fusion of these tissues. Some key points to consider about the closure of the foramen ovale include:

  • The prevalence of PFO decreases with age, occurring in 20-34% of the population 1
  • PFO has been linked to several conditions, including cryptogenic stroke, migraine with aura, decompression illness, and systemic arterial embolism 1
  • The data that support PFO closure in these conditions are mostly from nonrandomized cohort series, and are often contradictory 1
  • Recent evidence suggests that PFO closure reduces the risk of recurrent ischemic stroke in a highly selected population of stroke survivors 2 The closure is essential for normal circulatory function, as it prevents deoxygenated blood from bypassing the lungs. If the foramen ovale fails to close properly, it may require medical intervention, particularly if it causes symptoms or complications such as paradoxical embolism. It's worth noting that the most recent and highest quality study on this topic is from 2020, which provides the most up-to-date information on the closure of the foramen ovale and its relationship to PFO 2.

References

Research

Patent foramen ovale: anatomy, outcomes, and closure.

Nature reviews. Cardiology, 2011

Research

Patent foramen ovale.

Practical neurology, 2020

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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