Emphasizing that serious research should be done on PFO (cryptogenic) if the cause of stroke under 60 cannot be found, Küçükseymen said: “In addition, the frequency of clot formation in the veins of the legs (deep vein thrombosis -DVT) is is higher in patients who have had a stroke of unknown cause. The association between PFO and stroke of unknown origin is more apparent in young adults than in the elderly. “A person with PFO who has had a stroke of unknown cause was once at risk of 2.5 percent to have another stroke next year,” he said.
“Migraine patients with aura beware!”
Küçükseymen drew attention to the fact that the risk of being hit by PFO is 5 times higher in divers with PFO and continued his speech as follows: “Although the relationship between PFO and migraine is still not fully resolved, there are data that suggest that PFO has a role in migraine with aura. The frequency of PFO is known to increase up to two-fold in patients with migraine with aura compared to healthy subjects, and closing PFO reduces migraine-related headaches. Most people have no symptoms of patent foramen ovale. In rare cases, PFO migraines can occur, as can shortness of breath when getting up and standing. PFO manifests as a higher risk of certain types of stroke.”
“Diagnosis is made with a multidisciplinary approach”
Küçükseymen said: “Young adult (under 60 years old) patients who have had a stroke are subjected to an intensive examination by a neurologist to determine the cause of the stroke,” Küçükseymen said, adding: “The cases in which the cause cannot be found are evaluated together by specialists in neurology and cardiology.Since normal echocardiographic examination does not give very clear images in adult patients, echocardiographic examination of the esophagus (transesophageal echocardiography) should be performed in these patients.During this procedure the passage can be controlled by administering serum through the arm veins.
PFO closure required to eliminate stroke risk
Küçükseymen reported that transcranial Doppler scanning performed by neurology is a method that indirectly shows the presence of PFO and is performed by measuring the ultrasound signals generated in the cerebral artery by the serum administered from the vein in the arm. Küçükseymen said that while it is a more comfortable method, the diagnosis should be confirmed with echocardiography when the test is positive. The PFO closure procedure is decided after the risk of overdose and the foreseeable risks of the procedure are shared with the patient.
“PFO can be closed without surgery”
Küçükseymen said the PFO can be closed without surgery and said, “During the procedure, a needle is inserted through the groin (femoral vein) and from there a wire is sent to the heart and passed through the PFO. The closing device, which is placed in the correct size for the PFO is selected, it is advanced through the groin and passed through the hole. The device closes the hole by sitting on it from both sides. Before releasing the device, it is checked that the PFO is properly closed and that the inserted device does not damage other parts of the heart, at which point the process is terminated.Within 3-6 months after the procedure, the cell layer (endocardium) that lines the inside of the heart covers the closure device and the device now becomes part of the body .
Things to consider after the procedure
Finally, Küçükseymen explains what should happen after the procedure: “PFO closure takes about 1 hour on average. Depending on the devices used, the patient may be awake or slightly asleep during the procedure. After the procedure, the patient remains in bed for at least 6 hours and in the hospital overnight and is discharged in the morning. It is recommended to take blood thinners for a short time to prevent clot formation on the locking device. After resting at home for a few days, the patient can resume his daily activities. Situations that cause them to be beaten and contact sports (such as karate, boxing, wrestling, weightlifting) should be avoided for 6 weeks.