Question PFO Closure advice

[Capt Jim Wyatt]

Thanks! For divers having a closure, what is the recommeded recovery time recovery before diving?

Ask @Dr. Doug Ebersole - he does the closures.

 

[SpaceX Aquanaut]

Thanks! For divers having a closure, what is the recommeded recovery time recovery before diving?

Scubaboard Member who had the procedure done:

No diving for 3 months after the procedure

Thread '2 DCS hits and a PFO closure'

Dec 29, 2016

I've posted a lot on CDF about my bouts with DCS and having a PFO (parent Foramen Ovale) which greatly increases risk of DCS by not being able to decompress efficiently. I am posting here to give those that are not CDF members some insight about a PFO. A PFO is something everyone is born with and closes by itself in 75% of the population. It more often than not goes undetected but can cause some medical problems and greatly increases a divers DCS risk due to the bubble load. I've had 2 "undeserved" hits in the last year and a half and it turned out to be highly influenced by a PFO. It...

• Pullnglide
• Replies: 108
• Forum: Accidents, Incidents, & Near Misses

• 

 

[Dr. Doug Ebersole]

Ask @Dr. Doug Ebersole - he does the closures.

The recommendation is not to scuba dive for three months and to have a repeat transthoracic echo with a bubble study to verify complete closure of the PFO before returning to diving.

 

[Rokky]

The recommendation is not to scuba dive for three months and to have a repeat transthoracic echo with a bubble study to verify complete closure of the PFO before returning to diving.

Thanks!

 

[Keewee73]

Thanks! For divers having a closure, what is the recommeded recovery time recovery before diving?

Not sure if this is a universal answer but I had closure in February and was allowed to dive about 6 weeks later. Both cardiologist and surgeon were of the opinion that it had never been safer for me, from that perspective. (And I had 1-2 repeat bubble studies to ensure closure).

During the trip, I successfully dove without issue- kept the profile easy and used nitrox on the one deeper day. (The vacation was grand cayman, primarily easy shore dives). That said, I had some surgery related arrythmias during the healing process, and balancing the medications post procedure turned out a bit challenging, so I was prepared to skip the diving just because that wasn’t going my way and I wasn’t prepared to take chances. Fortunately we got things sorted out before the trip- but listening to your body is very important.

PFO closure is low risk, but that first 72 hours was still a bit scary- and the arrythmia problem really was irksome, bordering on concerning. The other complaint is they REALLY want you to avoid the dentist for 6 months. 5.5 months later, I’m sure I have a cavity or two. Take care of your teeth early. They are serious about not wanting you to have dental work.

 

[spc751]

I have been diving for over 40 years without issues. Most dives between 100 and 130 feet on air. Not long ago I discovered that I have a small PFO. I inquired about having it closed and was told that our medical system will NOT close it so I can dive. The advice I was given was NOT to dive at all. Or if I was to dive not to exceed 60 feet, dive on nitrox and no more than two dives a day. I am in BC Canada and this is the best that Canada’s “free” medical system will do for me.

 

[DanBMW]

Advise for anyone considering cardiac surgery. Get in the best shape you can before your surgery for the best possible outcome afterwards. I had mitral valve repair (heart murmur) surgery this past February and my recovery was almost effortless. Many with the same, but in poor shape before, did not fair so well and their recovery took quite a bit longer. Nothing to do with PFO, but the same organ.

 

[Duke Dive Medicine]

I have been diving for over 40 years without issues. Most dives between 100 and 130 feet on air. Not long ago I discovered that I have a small PFO. I inquired about having it closed and was told that our medical system will NOT close it so I can dive. The advice I was given was NOT to dive at all. Or if I was to dive not to exceed 60 feet, dive on nitrox and no more than two dives a day. I am in BC Canada and this is the best that Canada’s “free” medical system will do for me.

How was your PFO discovered? Were you tested after experiencing DCS?

Best regards,
DDM

 

[Pixel]

Not sure if this is a universal answer but I had closure in February and was allowed to dive about 6 weeks later. Both cardiologist and surgeon were of the opinion that it had never been safer for me, from that perspective. (And I had 1-2 repeat bubble studies to ensure closure).

During the trip, I successfully dove without issue- kept the profile easy and used nitrox on the one deeper day. (The vacation was grand cayman, primarily easy shore dives). That said, I had some surgery related arrythmias during the healing process, and balancing the medications post procedure turned out a bit challenging, so I was prepared to skip the diving just because that wasn’t going my way and I wasn’t prepared to take chances. Fortunately we got things sorted out before the trip- but listening to your body is very important.

PFO closure is low risk, but that first 72 hours was still a bit scary- and the arrythmia problem really was irksome, bordering on concerning. The other complaint is they REALLY want you to avoid the dentist for 6 months. 5.5 months later, I’m sure I have a cavity or two. Take care of your teeth early. They are serious about not wanting you to have dental work.

I am looking to schedule my PFO closure, and my cardiologist seems to think 6 weeks is good for returning to diving, after we repeat the bubble studies and determine it was successful. I would still be on Plavix - wondering if that is the rationale to delay returning to scuba? I understand the risks of the antiplatelet therapy...

 

[Dr. Doug Ebersole]

Data would suggest it takes up to 6-12 months to completely endothelialize the PFO device. During that time, the diver would be at risk for bubbles crossng through the device and would be at risk for clots forming on the device. Hence, it is usually recommended patients stay on dual antiplatelet therapy for around 6 months after the procedure. From a diving perspective, expert consensus statements from both SPUMS/UKMC and UHMS recommend no diving for 3 months and only returning to diving after a transthoracic echo with a bubble study show no further right to left shunting. Lastly, from a dental work perspective, patients frequently have transient bacteremia with dental cleanings. If there is still metal exposed on the PFO occluder, there is a risk of the device becoming infected. While this risk is quite low, it is recommended patients try to avoid dental procedures, if elective, for 6 months post PFO closure.