A New Treatment for a Heart Defect Reduces Strokes

A hole in the heart isn’t just what we feel when we lose people or pets we love. An actual hole in the heart, called the patent foramen ovale (PFO), is one of the most common heart defects, and having it can increase your chance of stroke.

Everyone is born with a hole between their heart’s two upper chambers. The flap-like opening allows oxygen-rich blood to flow directly to the heart while you’re in the womb, bypassing the lungs, which don’t function yet. In most people, the opening closes shortly after birth; but in about 25–30 percent of people it doesn’t.

Most people with an open PFO have no idea they have it and for most it doesn’t matter. But in some cases, blood that has not been cleansed by the lungs carries debris and blood clots through the opening. If a clot is carried to the brain, it can block a blood vessel, causing a stroke.

PFO is suspected in people who have had a stroke for which doctors couldn’t pinpoint a cause. The good news is that PFO can be detected by an ultrasound of the heart. The even better news is that a new, non-surgical procedure to treat PFO is now available at Pomona Valley Hospital Medical Center (PVHMC).

“The only way we could treat these patients previously was with blood-thinning medications,” said Ramanna Merla, MD, an electrophysiologist at PVHMC. “Now we can use a new device, called the PFO Occluder, to physically close the opening between the left and right atria that may allow a blood clot to travel to the brain and block a blood vessel, resulting in another stroke.”

The procedure is performed in the Cardiac Catheterization Laboratory. A device that resembles a tiny closed umbrella is threaded through a catheter inserted in the leg. When it reaches the heart, the device is opened and its two wire-mesh discs sandwich the PFO between them, sealing it. Over time, heart tissue grows over the implant and it becomes part of the heart.

The PFO Occluder was recently approved by the FDA for this use, said Dr. Merla. “It decreases, by a significant percentage, the possibility that a younger person who has had a stroke will have another stroke that could potentially cause a lifelong disability.”