My 75 yr old father has been diagnosed with a Attrial Septal aneurysm with large PFO and significant bidirectional flow after many TIA's and a couple of strokes over the last 10 years. My first question is would this cause a shortness of breath? and secondly should it be repaired

Hi there,

I’m sorry to hear about your father’s stroke and the challenges that he is facing in his recovery.

Yes, shortness of breath and fatigue are common symptoms associated with Patent Foramen Ovale (PFO).

We get a number of queries here on StrokeLine about PFO and whether closure is recommended.

Obviously every patient is different, and their management should be tailored accordingly, however our soon to be released Clinical Guidelines for Stroke Management 2017, provided the following general guidelines:

STRONG RECOMMENDATION: Patients with ischaemic stroke or TIA and PFO should receive optimal medical therapy including antiplatelet therapy or anticoagulation if indicated (Homma et al 2002 [203]; Shariat et al 2013 [201])

WEAK RECOMMENDATION (AGAINST): Routine endovascular closure of patent foramen ovale is not recommended. Endovascular closure may be reasonable in highly selected young ischaemic stroke patients after thorough exclusion of other stroke aetiologies (Kent et al 2016 [204]; Li et al 2015 [199]; Stortecky et al 2015 [200]).

You may like to read conversations that our EnableMe users have had about PFO here:

https://enableme.org.au/Community/Forums/View-topic?id=da2b9918-de4b-476d-b4cc-d586aed9dc0b

https://enableme.org.au/Community/Forums/View-topic?id=63e7e2ce-a464-4ac0-887c-ce9a28b15ada

https://enableme.org.au/Community/Forums/View-topic?id=9a159744-63d6-470d-9934-b0227d18bcd8

https://enableme.org.au/Community/Forums/View-topic?id=c762a139-ad1e-4c22-8798-6837f601a762

I can imagine how frustrating it must be for your father to receive such conflicting advice. Unfortunately we cannot give specific recommendations about whether your father’s PFO should be closed or not. I’d recommend that he go back to see his GP and discuss the risks and benefits of both options.

If you or your father would like to speak with our team of health professionals, please don’t hesitate to contact StrokeLine on 1800 787 653 (Mon-Fri 9am-5pm EST).

Best wishes,

Alana - StrokeLine