Patent foramen ovale is a defect in the heart that
fails to close naturally soon after a baby is born. In the fetal heart, blood moves in a different direction as
compared to an adult heart. Some of
the openings in the fetal heart close around birth. A failure to close one such opening between the left and right
atria (the two upper chambers of the heart) results in patent foramen ovale
. Though in many cases, these patients may not
require surgical treatment and lead a normal life, at times they are more prone
to develop stroke. This is possibly
since a clot formed in the blood vessels can pass easily through the foramen
ovale to the brain.
So, will closing
the patent foramen ovale surgically prevent strokes in these patients? To find
the answer to this question, a study was conducted across several countries
which compared patients undergoing the surgical procedure to those who were
treated only with medications to prevent clot formation.
The patients included in the study were less than 60
years old with a patent foramen ovale who suffered from a stroke or a milder
attack due to obstruction of blood flow to the brain or other organs like the
heart. The patients were divided
into two groups - one group underwent surgical closure of the patent foramen
ovale, while the other received only medications to prevent clot formation
. The patients who underwent the surgery also
received medications to prevent clot formation. The two groups were followed up for a period of around 4 years.
researchers found a slight decrease in the number of strokes in patients who
underwent the surgery, the protective effect of the surgery against stroke was
not significant. Thus, they conclude that surgery may not be necessary to
reduce stroke and other similar events in patients with patent foramen ovale,
who had already suffered a similar event in the past.
Percutaneous Closure of Patent Foramen Ovale in
Cryptogenic Embolism; Bernhard Meier et al; N Engl J Med 2013.