Thursday, April 30, 2009

Cardio Seal Closure

Surgery was quickly scheduled for October 17th, 2008. I would have a newer procedure where an implant called a cardio seal device is placed via my groin. It would be simple. Lasting, approximately two hours. One side of my groin would be used for threading the implant the other side would be used for a small camera to help with the device placement. They threaded my implant through my septal wall and popped each side up like a balloon with one quick pull.
These implants had not been FDA approved for PFO closures at the time, but having no time to really research I went ahead. The doctor never told me that fact nor did he tell me the after effects and feelings I would be having. Of coarse he explained the risks; which were far less than that of my other choice "open heart". Looking back, I don't think that my doctor was trying to hide any facts. He was merely trying to fix me the fastest and least aggressive way possible. The implant has been very successful in many others. Depending again on what medical journal you read it is on average 80% effective. In addition, those who have residual shunting(some leaking around the implant) manage to clear up in about 15% due to skin growth on top of the implant. It was very difficult to find any information about long term outcomes of the device. The few articles I read the implant dislodged, did not deploy correctly or the metal eroded over time. But, I was reassured that it only occurred in the older models developed before 2007. Still, it is unnerving to feel like an experiment.
The day of my surgery I was petrified. It's amazing what runs through your head. Everyone was very nice, but acted like this was an everyday thing. To them, "yes". To me I was going out of my mind. I was so close to getting up and running. Why? The fear of the unknown. How much pain would I be in? Would I have complications? What would a foreign body feel like? Will I always worry about this thing in my heart? I was put to sleep and a 33mm(almost an inch) implant was placed to close my defect. I woke up completely pain free. Just like a cardiac catherization a patient has to lay flat for a few hours. They use large catheters threaded through you veins or arteries. If you sit up the pressure could push your groin to have excessive bleeding. When you wake up, they check your blood clotting times through the catheters still present. After they are satisfied that your blood has thickened they remove the catheters. Removing the catheters is not painful at all. Kind of mind boggling on how long the catheters are. The painful part is the nurse holding extreme pressure where the catheters were. As I said I was pain free. But, all of a sudden it felt as if a BB gun was fired into my chest. For the first time I saw fear in my husbands eyes. I told him what I was feeling and without a word to me he called the nurse in. He told her to look at the monitor. My heart rate was all over the place. Even to the untrained eye it was obvious. The doctor was called and I was kept over night. My heart had become irritated from the new device placed. My doctor said eventually it would pass. Although beating pretty fast the strange arrhythmias(atrial fibrillation) did pass in the early morning. I was discharged home to take plavix(a blood thinner) for the next 6 months. I would also have a follow up TEE(and echo of you heart performed by going through your mouth into the esophagus) in 3 months. The TEE would keep an eye on the tissue growth around the implant and keep a check on the function of the implant.
At home the arrhythmias returned, I had constant chest pain for about 2 months(almost like a chicken bone stuck). I can say that I much rather would have pain than have the feeling that my heart was going to jump out of my chest. No one told me this was very common to occur. I had to find that out in all my research after the fact. I can tell you that I was scared and continuously petrified. I returned to work within three days. I suppose for some they would feel instantly better. But, that wasn't my luck! Again, after looking back I would have still chosen the procedure. Despite what you'll read later on. Really, the chances of what occurred next are very rare.


  1. I was the first person to have the seal in MN. I was 13 and in 8th grade, it was 1998. I was one of the first, and it took a few hours and they flew in docs from Cali and Florida. I am glad I could help to make your experience easy, cheers!

  2. My beautiful son had 5 cardio seals put in @ Boston Children's Hospital in 1994. At that time they were experimental. Now they are FDA approved & I feel so blessed that we have this miracle boy that will be 18 years old in 3 weeks !!!