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February 2005 :
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Innovative Heart Procedure
Innovative Heart Procedure
Baylor All Saints Offers Nonsurgical Repair for Patent foramen ovale
A physician at Baylor All Saints Medical Center used a tiny umbrella-like device to close a small hole in 24-year-old Amanda Davis's heart, performing the hospital's first nonsurgical patent foramen ovale (PFO) procedure last August.
PFO is a congenital defect, which means it is present at birth. About one in four people has this condition, which occurs when a flap between the right and left upper chambers of the heart, normal in the developing fetus, fails to close properly after birth.
Finding the Problem
Most people aren't even aware they have this defect. But Davis, a youth director at a Fort Worth United Methodist church and a student at Brite Divinity School, started having medical problems a year ago, including severe headaches and stroke-like symptoms called transient ischemic attacks (TIAs) for the first time in her life.
Her primary care physician, Angela Gibson, D.O., a member of the medical staff at Baylor All Saints, ordered dozens of tests to rule out multiple sclerosis and other illnesses. Dr. Gibson then sent Davis to Shirley A. Molenich, M.D., a neurologist on the medical staff at Baylor All Saints. After further testing for neurological disorders, Dr. Molenich suspected a heart defect and sent the young woman to Stuart Lander, M.D., an intervetional cardiologist on the medical staff of Baylor All Saints.
A Noninvasive Solution
Dr. Lander diagnosed PFO. In the past, when doctors thought PFO was a danger to the patient, open-heart surgery was required. Now, Dr. Lander is able to thread a tiny catheter from the leg up to the heart and into the flap, and then expand a miniature umbrella-like device to close the opening. Heart tissue eventually grows over the flap.
Davis says she feels great, although she continues to have discomfort in her arms when she's tired. She and her husband, Alex, recently returned from vacation in Cozumel, where the two enjoyed swimming and snorkeling. And she looks forward to the near future when she can enjoy roller coasters and scuba diving.
By Janan Talafer
For more information about PFO or for a referral to a physician on the medical staff at Baylor All Saints, please call 1-800-4BAYLOR.
What is PFO
Before birth, blood flows between the right and left atria (upper chambers of the heart) through an opening called a foramen ovale, which allows the blood to correctly bypass the lungs. The blood doesn't circulate through the lungs because the fetus relies on the mother for oxygen.After birth, the blood flow changes to send the blood through the lungs, eliminating the need for the foramen ovale, says Stuart Lander, M.D., an interventional cardiologist on the medical staff at Baylor All Saints. The opening is supposed to close and prevent blood from crossing between the two chambers. If the flap doesn't close, the condition becomes known as patent (open) foramen ovale (PFO).
Symptoms such as severe headaches, stroke and transient ischemic attacks (TIAs) may bring the possibility of PFO to a doctor's attention. Dr. Lander says physicians are investigating whether PFO is a factor in stroke patients, since the possibility exists for a blood clot to develop in the channel of the PFO or travel through the open flap and find its way to the brain.