Wow, I have personally spent lots of time advocating for this important stroke/PFO patient matter over many, many years but hard work has now paid off. The FDA announced last week the Amplatzer is now finally approved for recurrent cryptogenic stroke treatment in certain PFO patients!
Congrats and recognition for the commitment from the original team of PFO patients (formerly PFO Research Foundation in the US) that I began this important advocacy journey on with together so many years ago. Thank you!
Many patient’s report improvement in symptoms and sometimes even complete resolution of symptoms after PFO closure, while other patients report mixed results. If this applies to you, I hope you’ll chime in here how you feel after closure in this very unscientific anonymous poll:
So now for a quick PFO Closure Poll update, here’s how the polling results are going so far (340 responders to date)…
TCD is Superior to TEE for Detection of PFO (Patent Foramen Ovale)
AHAScience News-International Stroke Conference 2014-San Diego
Ralph Sacco, MD, FAHA, past-president of the American Heart Association, interviews David Spence, MD, primary investigator of the trial, “Transcranial Doppler Is Superior to Transesophageal Echocardiography in Detection of Patent Foramen Ovale,” which he presented at ISC 2014 in San Diego.
TCD and PFO Study Summary:
The researchers conducted a study to compare the performance of transcranial Doppler (TCD) with transesophageal echocardiography (TEE), the standard method for diagnosing a right-left shunt such as PFO. They hypothesized that transcranial Doppler saline studies would be more sensitive, in part because sedation for TEE could prevent an adequate Valsalva maneuver.
This question (and the answer below) appeared in today’s Resident e-Bulletin / Teaching Topics from the New England Journal of Medicine
Patent foramen ovale (PFO) is the most frequent cardioembolic risk factor for stroke in young adults. Others include congenital heart disease, infectious nonbacterial thrombotic endocarditis, rheumatic valvular heart disease, cardiac surgery or catheter intervention, arrhythmia (e.g., atrial fibrillation or sick sinus syndrome), cardiac tumors (e.g., atrial myxoma or papillary fibroelastoma), recent myocardial infarction, and dilated cardiomyopathy.
Up to 14% of all strokes occur in children and young adults. The incidence rates are 10 to 23 ischemic strokes per 100,000 young adults (18 to 50 years of age) and 3 to 9 hemorrhagic strokes per 100,000 young adults. Unfortunately, stroke remains under recognized and often misdiagnosed in young adults, particularly those less than 35 years of age and those with abnormalities in the posterior circulation.
To read more and to review a case study of an 18 year old patient at MGH that NEJM is featuring in their current issue click here