In this procedure, the provider inserts a thin, flexible tube called a catheter into a blood vessel in the groin area. A patent foramen ovale (PFO) is a hole in the heart that didn't close the way it should after birth.However, it may cause serious complications under certain circumstances. TLE can increase right heart pressures and mobilize debris, resulting in a righttoleft embolism and stroke via a patent foramen ovale (PFO). Patent foramen ovale closure is a procedure to close a hole in the heart. We use minimally invasive approaches to treat PFO without open-chest surgery. A patent foramen ovale (PFO) is a hole in the wall that that separates the heart's two upper chambers (atria). Learn more from Boston Children's Hospital. Patent foramen ovale closure is a procedure to close a hole in the heart. We use minimally invasive approaches to treat PFO without open-chest surgery.