CRMC Offers New Procedure to Help Treat Cryptogenic Strokes

The Cheyenne Regional Heart & Vascular Institute, a service of Cheyenne Regional Medical Center, offers a procedure to treat patients with a heart condition known as a patent foramen ovale. The procedure will be used to help people who have had a stroke that may have been caused by this condition.

What is a patent foramen ovale?
Before birth a baby’s heart has a natural opening in the wall between the left atrium and right atrium (the upper chambers) of its heart. This flap-like tissue opening is called the foramen ovale. The foramen ovale allows oxygen-rich blood from the mother to bypass the baby’s lungs, which do not function until birth. When the baby is born, the foramen ovale normally closes and seals within a few months. If the foramen ovale does not close completely, the opening is called a patent foramen ovale (PFO).

When is having a PFO a concern?
About 25 percent of people, or one in four individuals, has a PFO. In rare instances, this small opening can allow a blood clot to pass from the right to the left side of the heart. If the clot travels to the brain, it could block a blood vessel, resulting in a stroke.

How do doctors determine if a PFO may be the cause of a stroke?
About 87 percent of strokes are “ischemic,” meaning that they are caused by a blood clot blocking a blood vessel in the brain. About one-third of ischemic strokes are from an unknown cause and are called cryptogenic strokes. About 40 to 50 percent of people who suffer from a cryptogenic stroke have a PFO. When a PFO is found in someone who has suffered a cryptogenic stroke, the PFO is often determined to be the cause after ruling out other competing causes.

How is a PFO detected?
A transthoracic or transesophageal echocardiogram is often used to determine if someone has a PFO. During this procedure, a wand-like device is held on the patient’s chest. The wand, or transducer, creates sound waves that produce images of the heart. Doctors review those images to see if the patient has a PFO.

When should a PFO be closed?
Doctors may advise that a PFO be closed in people who are young and have had a cryptogenic stroke to decrease the risk of recurrence.

How is a PFO closed?
One way to close a PFO is for an interventional cardiologist to insert a device that plugs the PFO. The device is inserted on the end of a long flexible tube known as a catheter and is commonly performed in a cardiac catheterization lab.

The U.S. Food and Drug Administration has approved transcatheter closure of PFOs to treat patients who have had a cryptogenic stroke. Studies show that PFO closure is superior to medications alone in preventing a second stroke.

Is this procedure available in southeastern Wyoming?
CRMC was the first hospital in Wyoming to offer transcatheter closure of PFOs.

For more information about this procedure, please consult your provider. You can also find out more by contacting the Cheyenne Regional Heart & Vascular Institute at (307) 633-1600.