PFO Closure - Stroke Message Board

Peluci · 10-17-2004, 03:19 AM

Hello,

I received some very good information from stroke victims out there about how they went about closing thier PFOs. I fall into the group that has now had it closed surgically. I had a short incision sternotomy one week ago and I am feeling fine today. I will not be back to full physcial activity until 3 months from now, but the closure is permanent and I am off of coumadin with a completely negative bubble study and a perfect echocardiogram.

I was tempted to try mimimally invasive surgery using a robotic system to cut down on the incision but from what I could tell they don't have enough experience with this yet.

- Paul

aussie-angel · 10-25-2004, 05:31 AM

I had a mild stroke in April and a PFO was detected after a Transesophageal Echocardiogram. My Neurologist put me on Asasantin (a bloodthinner) and Zocor (for elevated cholesterol). He didn't think it was necessary for me to see a Cardiologist but after repeated nagging from family and friends, I saw a Cardiologist last week. I had a 24hr Holter monitor to check for Atrial Fibrillation which I have yet to get results from. He is awaiting the report from the TOE, I guess to see the size of the hole. My question is, how big does a PFO have to be before it is a) able to be fixed and b) liable to be the cause of the stroke? If it is repaired, does that mean a stop to the thinners? The Cardiologist is wanting to put me on Warfarin (lots of blood tests... no thanks!) but I don't want to be on medication for the rest of my life... I am only 39! Any info would be greatly appreciated.

Peluci · 10-27-2004, 11:03 PM

I had many tests done during my one week stay at the hospital following my stroke. I saw 3 cardiologists and 3 cardiothoracic surgeons. After going over all of my tests one thing that all 6 of them were in agreement with was that they thought my stroke was due to the PFO. I went on coumandin to buy time while I investigated a few options for PFO closure: device closure, sternotomy, or minimally invasive surgery. The device closure was the easiest option to accept surgically but had a number of potential complications and not enough testing to make me comfortable. Minimally invasive surgery (robotic) seemed like the best fit until I investigated the potential risks during operation with cardiothoracic surgeons. The conclusion that I came to after all of my discussions was that sternotomy is currently the safest procedure and has been used for successful PFO closures the most. My surgeon was able to do a minimal incision with a full sternotomy. The operation went great, the PFO is closed permanently, and I am off of coumadin for good. The only drawback is the 5" scar that I have mid-line down my chest. In a few months I plan to see my dermatologist and see what he can do to make this disappear. He is great - I think he is going to work some magic. I am a man and the idea of a scar in this area is probably allot easier to accept than a woman. I spoke to a woman who had a minimally invasive thoracotomy that was done below her breast and she seemed very happy with this. This operation may have a bit of increased risk over sternotomy due to limited exposure however. I hope that my experience here helps you some.

- Paul

aussie-angel · 11-01-2004, 03:58 PM

Thanks Paul. Glad to know all went well with you and you are off your medications. If after I see the doctor again he suggests closing the hole, I might contact you again. You seem to have done plenty of homework, which is great! Cheers, Jayne.

aussie-angel · 12-01-2004, 02:26 AM

Hey Paul, it was decided today between the Cardiologist and Neurologist, that I am to have the PFO closed. I am seeing the surgeon (who will do the procedure) next week but would like to pick your brains first on the options. The Cardiologist I see at the moment says I would have to be on the warfarin for about 6 months after surgery but I know you are off it. He also said I would need to stay on Asasantin (the thinner I'm on now) for the rest of my days. How old are you and what residual damage do you have from your stroke? If you can get back to me that would be great.
Cheers, Jayne