Patent foramen ovale (PFO) is common in asymptomatic adults, but imposes higher risk for transient ischaemic attack (TIA) or cerebral vascular accident (CVA). Trans-catheter closure of the PFO is now a common procedure in patients after cryptogenic CVA or TIA. No studies to date have assessed the psychological aspects of PFO closure.To assess the level of psychological distress, quality of life and optimism in patients post-PFO closure in comparison with healthy age-matched controls.A total of 89 patients who had undergone trans-catheter PFO closure and 60 age-matched controls were enrolled in the cross-sectional study. They answered demographic, health, quality of life, anxiety and depression and optimism questionnaires.PFO patients and controls reported similar levels of quality of life, depression and anxiety, although the study group reported a higher level of optimism. An age x group effect appeared for depression, indicating that older controls were significantly more depressed than their counterparts in the study group and than the younger participants in both groups. Optimism significantly accounted for the variance of depression, anxiety and quality of life, and age significantly accounted for depression and quality of life, while group also significantly accounted for depression.Post-PFO closure patients enjoy good psychological well-being and quality of life, and are more optimistic, which supports the view of optimism as a situational trait.