Patent Foramen Ovale (PFO): Closing the Door on a Second Stroke

Connie Kraynak and Dr. Steven Guidera | Doylestown Health

When an unexplained stroke in 2016 led to the discovery of a structural heart defect, Connie Kraynak, 67, of Hatfield, chose Doylestown Health interventional cardiologist Steven Guidera, MD, to close her patent foramen ovale (PFO) using an advanced, minimally invasive procedure.

A nurse director at another area hospital, Connie was out with colleagues, when suddenly, the pictures on her menu appeared to float. "I tried to stand, but fell. My left side was paralyzed," says Connie.

Stroke Diagnosis

At the nearest emergency room, Connie was diagnosed with a cryptogenic stroke—a stroke with no apparent cause. "I had no risk factors," says Connie. "I had low cholesterol, low blood pressure, never smoked and had no family history."

PFO and Stroke

Connie recovered completely, but tests revealed she had a heart abnormality. In about 25 percent of the population, an opening between the heart's upper chambers (atria) does not close completely after birth, a condition known as patent foramen ovale (PFO).

"If a blood clot arising from a vein in the leg crosses the opening, it can travel from the right to the left side of the heart and up to the brain, causing a stroke," explains Dr. Guidera.

Time for Closure

"When Connie had her stroke, PFO closure was recommended only for people who had more than one cryptogenic stroke," says Dr. Guidera. "However, follow-up studies demonstrated that PFO closure provides a significant benefit in reducing the risk of a second stroke, opening the door for repair to patients like Connie."

"Knowing my PFO increased my odds of a potentially debilitating stroke was worrisome," says Connie, a cardiac and intensive care nurse who supported many patients through stroke recovery before her 2018 retirement.

Quality and Outcomes

"My husband, Joe, a cardiologist, refers patients to Dr. Guidera. We value communication and outcomes, and Joe's patients talk about the personalized care and support they experience in Doylestown Health's Catheterization Lab," says Connie.

Minimally Invasive Remedy

Connie opted for transcatheter patent foramen ovale closure. Guided by precision imaging provided by Dr. MaryAnn Williamson, Dr. Guidera delivered a self expandable mesh and polyester dual disc device via a catheter, through her femoral vein and up to the heart. Positioning a disc on each side of the opening, he released the device, permanently sealing Connie's PFO.

"My patient experience was incredible," says Connie, "The team explained everything and answered all of my questions."

After a one-night hospital stay, Connie began her next life chapter—traveling, volunteering, and enjoying her family—without fear that her PFO would increase her risk of another stroke in the future.

About Doylestown Health's Heart & Vascular Services

Expert cardiologists and cardiac surgeons assist patients and physicians with managing risk factors for heart disease, offer advanced treatment options and provide outstanding emergency cardiac care. Doylestown Hospital’s accredited Chest Pain Center is fully prepared to treat cardiac emergencies around the clock, focusing on rapid diagnosis and effective treatment. The multidisciplinary team at the Woodall Center for Heart and Vascular Care is dedicated to providing the highest level of quality care and patient safety.

About Stroke Care at Doylestown Health

Doylestown Hospital follows national guidelines that can greatly improve long-term outcomes for stroke patients. The Joint Commission awarded Doylestown Hospital with the Advanced Certification for Primary Stroke Centers in recognition of our commitment to excellence in stroke care. As part of this multidisciplinary program, Doylestown Health interventional cardiologists perform an innovative non-surgical stroke treatment for large vessel blockages through Intra-Arterial Thrombectomy (IAT) to remove a stroke-causing clot thus resolving stroke symptoms immediately.

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