Understanding PFO and Its Impact on Stroke Risk

Episode 81: Managing PFO after Stroke: A discussion on diagnosis, treatment options including the patient perspectives and quality of life decisions with David Thaler,MD of Tufts Medical Center.

This conversation in collaboration with the SAYA Consortium explores the relationship between patent foramen ovale (PFO) and stroke, particularly in young adults. Our expert guest, Dr. David Thaler, a vascular neurologist with Tufts Medical Center, discusses the definition of PFO, its diagnosis, and its implications for stroke risk. The discussion highlights the importance of understanding cryptogenic strokes, which often have no identifiable cause, the PFO paradox and how a PFO is often discovered with cryptogenic strokes, the diagnostic tests and the management options available for patients with PFO. The conversation emphasizes the need for patient education and awareness regarding stroke risks and prevention strategies. In this conversation, Dr. Thaler discusses the implications of PFO closure in recurrent stroke prevention, medical management and the importance of patient choice and quality of life, plus the outcomes of the RESPECT Trial. Co-host David Dansereau shares his patient experience as a stroke survivor with PFO who elected for device closure.  The dialogue highlights the evolving landscape of PFO research and the significance of understanding individual patient risks and lifestyle choices.

More About Our Guest: David Thaler,MD-Tufts Medical Center

Show mentions:  Lester Leung,MD,  Katelyn Skeels, SAYA Consortium, RESPECT Trial , Co-Host David's Book Closure

Thanks to: Rory Polera (guest on Ep.69), stroke survivor and interview outline reviewer with SAYA Consortium

Additional Education:

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Chapters

• 0:00 Co-Hosts explain collaboration with SAYA Consortium for this educational project on PFO
• 9:28 Guest Intro-Welcome Dr. David Thaler, MD
• 15:27 Understanding PFO: Definition and Diagnosis
• 25:05 The Connection Between PFO and Young Stroke Patients
• 31:58 Cryptogenic Stroke: The Mystery of Unknown Causes
• 40:04 Management and Treatment Options for PFO
• 46:46 PFO Closure vs. Medication: A Patient-Centric Approach
• 52:29 Post-Procedure Management and Medication Guidelines
• 55:47 The RESPECT Trial: A Landmark Study
• 1:00:40 Future Directions in PFO Research and Screening
• 1:09:59 Migraine and PFO: Exploring Connections
• 1:12:28 Patient and Family Questions and Closing Remarks