Diving with a PFO

[slindblade]

After an unexplained dcs hit last fall, I had an echo test with bubbles that revealed a PFO. I am interested in hearing the guidelines of diving with a PFO as well as the pros and cons of having the surgery to close it up. Thanks for your help!

 

[DocVikingo]

Start here, 'blade:

Alert Diver | PFO and Decompression Illness in Recreational Divers

Alert Diver | Divers with Holes in their Hearts

Regards,

DocVikingo

 

[Dr. Doug Ebersole]

The management of PFO in divers with unexplained DCS is very controversial. For this reason I am doing a studying conjunction with DAN to help make recommendations to divers in the future. More info is here: DAN: Divers Alert Network - Scuba Diving and Dive Safety Association

As a technical diver/instructor and interventional cardiologist who closes PFOs as
part of my job, I would be happy to discuss pros and cons of pro closure versus
conservative diving practices with you any time.

Doug

 

[slindblade]

The doctor recommends ultraconservative diving, about half of what the tables allow. I was planning to leave my computer on air and dive with nitrox, but he seems to think that might not be conservative enough. Anybody have ideas on how to use the computer (a Mares RGBM M1) to calculate this..... or a computer that would be even more conservative than this one?? I'm ready to hear any ideas you've got!

 

[SeaHorse81]

I'm curious to know if the doctor recommended any specific depth limit, or is he meaning that you just dive where you want but stay a lot farther away from the NDLs? I'm guessing it's a combination of both.

It occurs to me that it would be a lot more conservative to go back to diving air tables, especially on Nitrox, and especially if you assume another 10-20 feet of depth for your calculations.

 

[knotical]

Since a valsalva maneuver can trigger a shunt (see for example, this article: Patent Foramen Ovale ), I suggest you use other, passive techniques for equalizing, such as jaw thrust, swallowing, etc. if diving with an uncorrected PFO.

 

[Dr. Doug Ebersole]

Reply to your PM sent.

Doug

 

[Duke Dive Medicine]

After an unexplained dcs hit last fall, I had an echo test with bubbles that revealed a PFO. I am interested in hearing the guidelines of diving with a PFO as well as the pros and cons of having the surgery to close it up. Thanks for your help!

Slindblade,
It looks like Doug's got a good handle on your case, but for my own edification, can you elaborate on your DCS hit a little? What was your dive profile, what were your symptoms, and how long after your dive did you feel them?
Best,
DDM

 

[slindblade]

sent you a PM

 

[slindblade]

Just got back from a full week of diving on the Caribbean Explorer II in St. Maarten, Saba, and St. Kitts. Amazing!! I left my computer on air while using nitrox, didn't get closer than 5 minutes to deco, came up VERY slowly and doubled my safety stop times. No problems whatsoever - it felt so GREAT to be back underwater - I am still so excited!!!