Block Development:
[Technology is revolutionizing the treatment of stroke]
Stroke continues to be a leading cause of death and disability in the country. While significant advancement has made in the treatment of stroke. There is a need for an in-depth study of causative factors to understand its root cause. Fifty percent of strokes in those below 60 years caused by an opening. In the partition between the two upper chambers of the heart that failed to close fully after birth. This opening referred to as patent foramen ovale (PFO). There is very little awareness about the treatment options for these patients. Advances in catheter-based therapy have paved a way for treatment. These patients are more effective and safe as compared to the more potent blood thinners, which were the only option.
PFO and its Cause
Prior to birth, there is an opening in the heart partition, between the right and left upper chambers. This opening allows blood enriched with oxygen from the mother’s placenta to bypass. The baby’s lungs do not function until birth. Once the child is born and the lungs become functional, a tissue flap closes. The opening and within a few months sealed completely. In about 25-30 percent of babies, the foramen ovale tissue flap does not close completely. When the foramen ovale remains opens, it called patent foramen ovale.
Although PFO is common, in rare cases. It allows a blood clot to pass from the right side of your heart. The left side of your heart bypassing the lung filter, and then travel to the brain. Where it can block a blood vessel, resulting in a stroke. Therefore, the presence of a PFO is believed to a factor. That could lead to an ischemic stroke in the young.
How Technology is coming to the Rescue?
Among the many treatment options available today, there are different kinds of occluders. That can place in the heart to close the PFO using a minimally invasive catheter procedure. The procedure involves puncturing a vein. In the groin and inserting a small catheter to guide the occluder into the heart. This occluder closes the opening in the heart. Once the device is placed across the PFO, the implanting cardiologist carefully studies it. Its position using cardiac imaging tools. Once the cardiologist is satisfied with the position of the occluder. The device is released to remain permanently. In the heart and all the catheters removed to complete the procedure. After the procedure, the patients can return to normal activities in a couple of days.
PFO closure with a device has proven to reduce the recurrence of strokes significantly in patients with PFO related stroke, especially in the younger population (< 60 years). It can also reduce the risk of bleeding associated with the long-term use of blood thinners that have used conventionally. Most people can take blood thinners for years without a risk. Since blood thinners help prevent blood clots, even tiny cuts or bruises will bleed a lot more. When these drugs consumed daily and therefore will necessitate a change in lifestyle, like. The inability to participate in contact sports or undertake activities. That has the potential to cause trauma or injury.
The other disadvantage of this group of medicines. Their interaction with certain food and with other medicines routinely used for cough, cold, and fever. They also require regular blood monitoring. Stroke is becoming a major cause of death in low-income and middle-income countries like India. What we need today is a focus on early diagnosis, public awareness, and capacity building. At different levels of health care. It is important to live a healthy lifestyle comprising appropriate diet, regular physical activity, avoiding smoking, controlling blood pressure and diabetes, limiting or avoiding alcohol, and modifying the response to stress.
The writer is a consultant interventional pediatric cardiologist, Madras Medical Mission, Chennai.
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