Heart surgery for patent foramen ovale may not always reduce the risk of stroke and other complications due to clot formation, according to recent research.
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.
AdvertisementSo, 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.
Though the 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.