Tuesday, March 26, 2013

PFO closure still an open question

The question of plugging a hole in the heart - a patent foramen ovale, a possible stroke risk - made medical news a few days ago.

MedPage's article PFO closure still an open question came with the following bullet points:

  • Two new randomized studies found that there was no significant benefit associated with closure of a patent foramen ovale in adults who had had a cryptogenic ischemic stroke.
  • Point out that in one of the studies, there was a significant between-group difference in the rate of recurrent stroke that favored treatment among those in the pre-specified per-protocol and as-treated analyses, but that the low overall rate of events in both studies raises statistical questions about this result.
I have a vested interest in PFO closure because mine was closed in the summer of 2007. As a result, I no longer take the medication warfarin, which has its own risks.

Now, the research is indicating that PFO closure outcome is, statistically speaking, about the same in terms of preventing future strokes. There's a lot of language in the stories I read about making case-by-case decisions as to whether the procedure is a good idea.

From my vantage point, I am still glad I had this done. Fewer medications. Fewer side effects. Warfarin was giving me headaches and, especially for someone relatively young who tries to be active, can cause excessive bleeding.

Is that a good choice for everyone? Certainly not. Each individual's circumstances should be considered.

(Video of the implanting of my PFO occluder)

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