i ended up having a small TIA and was hospitalized. at that time, they did a TEE on me and found that i had an ASD, not a PFO and ASA. that, coupled with the TIA made it easier for me to get the procedure done. i still had to fight with my insurance to pay for me to go to chicago to get it done. (my ASD was a tricky one, and the only doc who had a chance of fixing it was dr ziyad hijazi at university of chicago. he's the guy who travels the world training docs to do the catheter procedure. he's amazing, personally and professionally. and if you end up having a hole that's hard to close, he is your guy! he closed mine percutaneously with the amplatzer. it was easy, i was awake for the whole thing, in and out in a day, and my heart has been great ever since.)
but, back to PFOs and the ongoing controversy about whether or not to close them. i'm not sure it's still the case, but back when i wanted it, the closure device was still considered an experimental device in regard to PFOs, meaning the FDA would not allow it unless it could be proven that it was needed "for compassionate use". i'm not sure whether it's the patient or the doctor that needs to petitition, and whether it's to the insurance company and/or the FDA, but if you ask your doctor, hopefully, he/she will know.
as for me, i was ready to tell them i couldn't live my life waiting for a stroke big enough to warrant closure.... and then i had my stroke.... and it was a moot point...
hope this helps....
janice