A better way to prevent strokes? 

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A potentially life-saving treatment for stroke prevention has been performed for the first time in Australia, at Gold Coast Private Hospital.

Cardiologist Associate Professor Ross Sharpe said the non-invasive technique is 100 percent accurate in detecting a possible abnormal connection in the heart, whereas traditional procedures can miss 15 percent of such holes – a quarter of them being large.

The condition, known as Patent Foramen Ovale (PFO), is normal for babies in the womb as it helps circulate oxygenated blood. However, if the hole does not close after birth, the resulting flap between the upper chambers of the heart can result in small clots bypassing the lungs, entering the brain and blocking the artery, causing a stroke.

“The incidence of PFO is much more prevalent in the younger population than first thought, affecting up to a third of people aged up to 12 years. If left undetected in a stroke victim, a PFO can lead to further strokes,” Dr Sharpe said.

The standard test for PFO detection is a trans-oesophageal echo (TOE) – a probe is passed down the throat into the oesophagus to take ultrasound images of the heart, and has to be performed under anaesthetic in hospital.

However, Dr Sharpe has turned to a technique known as contrast Trans Cranial Doppler Ultrasound (cTCD), which he performed at Gold Coast Private along with Assistant Professor Dan Traves, a sonographer.

“cTCD is a better, cheaper, safer and quicker test to detect a PFO than the current standard procedure,” Dr Sharpe said. “It can be performed in the consulting rooms in less than 15 minutes and involves injecting a saline solution into the blood stream to see if it reaches the brain. If it appears in the brain, this would suggest the patient has a PFO.”

Research has shown that PFOs are also linked to migraines with aura, exertional fatigue and breathlessness, divers’ decompression illness, altitude sickness and even many life-shortening diseases, Dr Sharpe said.

As chairman of the PFO Research Foundation, he has been working on new methods for closure once it has been discovered.

“The non-surgical treatment of PFO complications such as stroke typically involves a life-time of blood-thinning medications like Warfarin, but in my experience, closing it is the most effective course of action.

“Three highly-regarded studies have recently shown that the hole should be closed and is superior to medication in preventing further brain attacks,” Dr Sharpe said.

He has developed and altered the techniques to allow for minimally-invasive PFO closure to be done in just 20 minutes with same-day discharge – finding the hole and closing it with a patch via a catheter inserted in the groin vein.

Dr Sharpe said he has also applied the technique to patients suffering severe migraines who have not benefited from usual treatment, and closure of their PFO has allowed them to resume a normal life.

“Our results have been presented at a major international conference in Europe and we have attracted significant funding for more research. Those studies are about to begin.

“I believe we have only scratched the surface of the PFO story and there is potentially many more negative impacts it may be having on the human condition,” he said.

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