The management of Patent Foramen Ovale in stroke webinar

Presented by Dr Matt Daniels, Consultant Cardiologist, Manchester Royal Infirmary

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Patent Foramen Ovale closure to prevent recurrent stroke

Agenda

1. Review Randomised control trials on PFOC vs medical therapy (20min)
   • Patients included in trials – Age & comorbidity
   • How was PFO defined – what is a positive bubble test?
   • What was “medical therapy”?
   • What devices were used – were there any differences?
2. What was the outcome?PFO closure in the UK – understanding how the goalposts have moved
   • A review of historical practice (pre 2013)
   • Commissioning through evaluation period (2014-17)
   • Commissioning through evaluation outcomes
   • Re-commissioned service (post 2019)
   • Impact on UK activity & cardiac services in particular
   • The typical patient pathway to PFOc – how do we deliver the service in the real world?
3. Index stroke
   • Young stroke investigations – what is needed?
   • PFO screening
   • PFO MDT discussions
   • preadmission/first cardiology contact
   • The PFO closure procedure
   • Follow up
4. Opportunities and uncertainties in PFOc – some case examples