AAN publishes updated practice advisory on closure of common heart defect after stroke

AAN publishes updated practice advisory on closure of common heart defect after stroke

Simple blood test offers early warning of chemotherapy-related cardiac dysfunction For the practice advisory, clinical experts carefully reviewed the available evidence about stroke prevention in patients with a PFO who had already had an ischemic stroke, which is a stroke caused by a blockage in a blood vessel leading to reduced blood flow. When considering PFO closure in people who have had a stroke, the practice advisory recommends that doctors with expertise in stroke to first rule out causes other than the PFO, such as hardening or a tear of the blood vessels, heart disease including abnormal heart rhythms, or an increased risk for forming clots, to ensure that PFO is the most likely cause of stroke. The practice advisory does not recommend PFO closure if another higher risk cause of stroke is identified. The advisory also recommends that patients considering closure have a consultation with an expert in PFO closure, to ensure that the procedure can be safely performed. The practice advisory states for people younger than 60 years old who have had a stroke thought to be caused by a PFO and no other cause, doctors may recommend closure of the PFO after discussing the potential benefits, including a 3.4% reduction in the risk of a second stroke in five years, as well as the potential risks, such as a 3.9% chance of procedural complications and an increased risk of an abnormal heart rhythm called atrial fibrillation of 0.33% per year. "The risk of a second stroke in people with PFO and no other possible causes of stroke is very low, approximately 1% per year while being treated with just medication alone," said Messé. "Also, it is difficult to determine with absolute certainty that the PFO is the cause of a person's stroke. So it is important that people with PFO are educated about the benefits and risks of PFO closure." The advisory recommends that for people who choose to take medications alone, without PFO closure, doctors may consider prescribing aspirin or other antiplatelet drugs to prevent blood clots, or anticoagulant drugs such as warfarin, also known as blood thinners. Source:



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