Presented by Dr Matt Daniels, Consultant Cardiologist, Manchester Royal Infirmary
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Patent Foramen Ovale closure to prevent recurrent stroke
- 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?
- 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?
- Index stroke
- Young stroke investigations – what is needed?
- PFO screening
- PFO MDT discussions
- preadmission/first cardiology contact
- The PFO closure procedure
- Follow up
- Opportunities and uncertainties in PFOc – some case examples