The risk of stroke is greater in patients who have a frequent heart defect: a patent foramen ovale.
Each year, 140,000 cerebrovascular accidents (CVA) are recorded in France. It is the leading cause of acquired physical disability in adults. They are due to the occlusion of a blood vessel in the brain caused by a clot. Most of the time, the clot formed due to heart or arterial disease.
But in 30 to 40% of cases, none of these underlying diseases can be blamed. In contrast, a very common heart defect, the patent foramen ovale, could be associated with some of these unexplained cases.
A French team, led by Prof. Jean-Louis Mas, head of the neurology service at Sainte-Anne Hospital (AP-HP), has shown that a surgical operation to correct this anomaly significantly reduces the risk of recurrence. stroke.
A very common anomaly
The foramen ovale is a hole that connects the two atria of the heart. Open during gestation, it usually closes after birth. When it does not close completely, it is called a patent foramen ovale. This anomaly affects between 10 and 35% of young adults.
The work carried out for several decades tending to show that this anomaly favored the occurrence of stroke, and recurrence, Prof. Mas and his team from Inserm, Paris Descartes University and AP-HP carried out a large clinical trial, over 10 years. They publish the results in the review New England Journal of Medicine.
No recurrence
Between 2007 and 2016, they followed 663 patients aged 16 to 60 who had already suffered a stroke attributed to the patent foramen ovale. Some of them took the usual treatments (antiplatelet, anticoagulants), and others underwent surgery to close the foramen ovale.
The results clearly showed that the intervention significantly reduced recurrences: none occurred among the operated patients, whereas in the control groups, they could reach up to 6% of the patients. And the complications were very limited. The surgery is endovascular, it does not require opening the rib cage.
The group of neurologists has therefore managed to show that the intervention is useful, but not only. They also validated the theory that a patent foramen ovale could promote the onset of stroke. The operation could represent an interesting therapeutic response.
.
