The “defect” from a patent foramen ovale (PFO) is a one-way valve that, in most, is sealed soon after birth. However, in 25% of the population, this valve (foramen ovale) remains patent thus creating an intermittant communication between the upper chambers of the heart (the atria) that transiently allows passage of blood from the right atrium to the left atrium. Unlike an atrial septal defect (ASD), this “hole” is closed some of the time and opens only when pressures in the right atrium increase. The primary risk to patients with a PFO is that of an embolic stroke. Small clots and debris that are usually filtered by the lung are allowed passage via the PFO into the left side of the heart and to the brain. Similar to ASDs, two current treatments exist for closing these defects, surgical (open-chest/heart) and catheter-based (nonsurgical). Both are safe and effective ways of managing PFOs and both prevent the adverse effects described above.