PFO Closure this past Friday, May 16

I'm writing this for my mother.

She had the right heart catherization on Friday afternoon to close a hole in her heart.

She was diagnosed with small hole in the right side of her heart 2-3 years ago. Doctors at her old hospital for medical care actually told her there wasn't really anything they could do about it and that it may suddenly get worst one day and that would be it. We decided to take her care to one of the betters hospitals in New York, which is Presyterian. My mother has lung disease so one of the things they consider while analyzing the lung disease is if there's anything contributing to it. Her shortness of breath has been out of proportion with her lung disease so they felt her heart could be contributing to the situation. So a transecho with bubble study followed suit. Doctor said the hole was pretty small but that a large amount of bubbles were traveling through the hole. She recommended closure because she feels it could help my mothers shortness of breath and some of her other symptoms.

Procedure day.

Took some extra blood tests to make sure everything was good. They marked pulse areas from her feet and legs. They shaved the groin area. Everybody was really nice.

My mother said she felt everything during the procedure as they just numb the area. Sidenote: She also felt everything of a former colonoscopy she had and said the colonoscopy was worst. I'd describe what she described to me as more discomfort than pain. She said they had a big screen where you could see everything from the inside and there was a woman there noting numbers all the time (I would guess those were pressure readings). They took her in around 2 pm and she was out at approximately 3:30.

Afterwards, she basically had to stay in the same position for 6 hours. Flat. There was a straw like element in her leg, groin area that could break if you bend your leg. That can cause a bleed. That's removed but they still keep you in the position for 3 hours more. She was allowed to eat dinner. She was hungry so she ate that food flat on her back. A nurse positioned the bed at an angle when she was almost done and that made eating easier.

She had some bad heartburn following the procedure that went away with Mylanta. She generally has right hip pain, so the bed rest and the procedure itself didn't help. Her groin area still hurts. It hurts more when she's trying to do too much. When she's resting, it's more like occasional waves of light/moderate pain/discomfort with a sharp attack every so often. She got her first nose bleed on Sunday morning as they added 3 months of Plavix to her Aspirin regiment. Will keep everybody up to date on how it goes from here.

Wound check will follow in 1-2 weeks. Transecho with bubble study is scheduled for 3 months to see if the procedure is a success, at least in terms of closure. In terms of symptoms, right now, can't really tell if there is any improvement.

Hello Priam,

Can you tell me which doc performed the procedure ?

Cheers
Pamposh

Dr. Geoffrey Bergman is the physician officially listed for the procedure. He was in the room with my mother leading the procedure BUT she said it seemed that a different physician was actually doing the hands on work. I have to say she seemed most disturbed by the sensation of severe heartburn she had through her chest after the procedure. I think I mentioned, that went away a few seconds after taking the Mylanta. Right before the procedure, they give you a verbal list of things that could happen during the procedure which include a stroke or heart attack. Don't be shocked by that. It's rare. They also tell you that if less than 3 of your arteries show to be clogged, they will unclog it during the procedure.

Some details about my mother. She's 66. She has ILD which has been diagnosed since 2004. It's recently shown to have progressed a bit which is why they went ahead with the closure of the heart in the first place. They want her to be in better condition should everybody decide a lung biopsy is in order. I'm against the lung biopsy but we'll see. In March, they discovered my mother has high ammonia levels and that caused the delay of the closure of the hole in the heart until this past Friday. BTW, this also causes her platelet count in her liver to be low WHICH is an issue because the Plavix causes low platelet count too. GI appointment coming up where this will be discussed. All of these conditions she has lead to a lot of the symptoms she has - shortness of breath, general weakness, dizziness, and stroke like symptoms in general.

Dkel, indeed, on the second opinion. At her old hospital they never really discussed her medical conditions with her in the way they should if at all. And, yes, so far it's been alright. She's doing what she needs to do to lower her ammonia levels which has decreased the amount of ER visits she's been forced to make. Lower ammonia levels equals Lactulose. We're hoping everything will come together and we will see even more improvement with her symptoms but we understand it will probably take time.

Of note, I will add she's having some mood swings. I'm thinking may be caused by the Plavix. She's a little more emotional than usual. Less able to contain her emotions.

Update. This Friday will be 3 weeks since the PFO closure.

My mother was feeling pretty good with her shortness of breath the first few days following the closure. Then she experienced several episodes of pretty severe shortness of breath (more prominent than before the procedure). Doctor Bergman told her to come in and they admitted her for about 3 days.

They did an echo with bubble study and the report says she has a significant growth in stunting in comparison to the shunting in the echo the day after the procedure (they were taken about a week apart). The internal medicine doctor who talked to us said he believes it's normal from what the cardiologists told him. I'm a little concerned, after all they did keep her in the hospital for 3+ days and she was reluctant to stay. I really want to know how the last echo compares to her initial echo in February.

She's still having significant shortness of breath issues. Today's been a pretty bad day with it. She has a follow up with her normal cardiologist on the 16th. I'll make sure to state my concerns and hopefully get answers on that day.

She's battling some depression. Whenever she feels things are worst and not any better, you can see it's taking a toll on her. She expected this to really help. I told her sometimes it takes a couple of months. The doctors told her she's got to look at the first couple of days after the procedure and see that ultimately the closing did help therefore will help. She just absolutely dreads the thought of going to the hospital for anything other than appointments.

One thing that's been worrisome to me since her procedure is she's asking "what?" a lot more. I need to question her cardiologist about the effects her medicine may be having on her mental state.