Anniversary of hole repaired

Close to the end of the day today, June 25, 2008, remembered that this is the first anniversary of the procedure that plugged a hole in my heart.

My 1998 stroke was likely caused by a small hole between the two atrial chambers, called a patent foramen ovale. Everyone is born with the hole and most of the time, it seals up shortly after birth. And add another defect: The wall between the two chambers, called the atrial septum, should be smooth and flat. If so, even a patent foramen ovale is unlikely to cause a problem. In some instances, though, the atrial septum is misshaped, called an atrial septal aneurysm. The hole and the aneurysm combination increases the chances of a problem.

Normally, the right atrium receives blood from the vein side of the circulatory system, then passes it along to the lungs. In addition to processing oxygen for the blood supply, the lungs also use a filtering mechanism to remove debris, such as clots. From the lungs, the blood is moved back to the other side of the heart and pumped out to the arterial system, supplying oxygen-rich filtered blood to the body. However, if the atrial septum has a divot, if you will, then debris can collect. When pressure builds up in the chest -- say, from coughing or sneezing -- then blood and debris can move through the patent foramen ovale from the right atrium to the left atrium, circumventing the lung's filtering system. Unfiltered blood is pumped out into the body, including the brain.

Because of this, 10 years ago I experienced a cryptogenic stroke -- that is, a stroke with no obvious cause. In April 2007, a much more minor episode occurred, which triggered a round of tests. As long as the conditions remained, my risk of stroke was several percentage points higher than the rest of the population, despite the fact that I don't smoke, have low cholesterol levels, excellent blood pressure readings and, being a distance runner going on 20 years, am generally quite fit.

Thus, a year ago, I went through a procedure, in which a doctor snaked a couple of tubes through some arteries and deployed a device that plugged the hole. Within six weeks, I was back to normal. After six months, I received a final OK that the hole was completely sealed. No more restrictions, no more prescription blood-thinner, no higher stroke risk than the rest of the population.

Found a video about the procedure, including the very same doctor who did the work at Barnes-Jewish Hospital in St. Louis. If nothing else, I hope this gives someone reassurance that even a hole in the heart can be defeated.