I have a PFO and atrial aneurysm. I am scheduled for a transcranial Doppler and PFO closure.?

Question

I suffered a TIA about a year and half ago and they think that this event was due to the PFO. I just found out I had it and was a little upset. I am having the nonivasive procedure instead of open heart. I was just wondering if anyone out there has and the same thing or simiuliar happen to them. Thanks for any help.

Answer 1

Tina - I'm sorry to hear about your TIA. Having a PFO closed for strokes is not a terribly rare thing to have done these days. If you follow sports, you may be aware that Tedy Bruschi, the New England Patriots linebacker, went through the same procedure a couple of years ago.

Have they already found a PFO in you? Usually transcranial Doppler is used to help make the diagnosis, so if they already know you have a PFO, I'm not sure what doing a transcranial Doppler would add.

One thing you should know is that there is NO RESEARCH at this point in time to tell us if closing a PFO is better or safer than taking an aspirin or blood thinner to prevent recurrent strokes. A couple of trials are going on right now to make that determination. These are the CLOSURE-I trial and the RESPECT trial. Unfortunately, we are not expecting any results for a couple of years. These trials are looking to see if someone who has had a stroke or TIA (documented by head CT or MRI) and has no obvious causes besides a PFO will be at lower risk by having the hole closed versus taking an aspirin or a blood thinner. Until those results are back, what data we do have suggests that taking a pill is just as effective as having the hole closed.

The FDA does not currently approve PFO closure for TIA or stroke, but closure can be done under an Investigational Device Exemption (meaning as part of a clinical trial). However, there are plenty of cardiologists out there who will close one without an FDA approved indication.

If you have any further questions, please feel free to send me an email. Hope that helps!

Here's an article about the subject that you might find interesting, although it may be a little too technical...
http://www.ccjm.org/PDFFILES/Furlansuppl1_07.pdf