Explaining Bret Michaels’ Heart Surgery
September 25, 2010
Deborah Huso of www.aolhealth.com reports: Bret Michaels is scheduled to undergo more surgery come January, this time to close up a small hole in his heart. Plagued with health issues over the course of the last year, the 47-year-old singer, actor and TV personality suffered a brain hemorrhage in April and then a stroke in May. By comparison, however, the hole in his heart is a minor issue.
Known as a patent foramen ovale, the hole is a common condition, which affects anywhere from 18 to 24 percent of the general population. Most people don’t even know that have it, and it’s not life-threatening. In Michaels’ case, however, doctors feel it may have had some relationship to his stroke last spring.
The foramen ovale is a tiny hole located in the atrial septum and is used as a supply route for the travel of blood to the heart from mother to fetus before birth. Normally, the foramen ovale closes at birth. When it doesn’t, it’s known as a POF, and it may open and close like a flap valve when a person sneezes, coughs or has bowel movement.
Most people who have PFOs don’t even know it, as there are no symptoms, and the hole is often detected only once a patient has received an echocardiogram. Doctors discovered Michaels’ PFO following his stroke, also known as a transient ischematic attack. His neurosurgeon believed the stroke may have been caused by the PFO, which could possibly have led to reduced blood flow to the brain. PFOs are more commonly associated with stroke risk in people under 55 where there is no other evident cause.
Dr. Wade Smith, director of neurovascular services at the University of California San Francisco Medical Center and member of the American Academy of Neurology, says whether or not closing up a PFO will reduce one’s stroke risk is still a question experts are trying to answer. “We don’t know if PFOs lead to stroke,” he says. “We look for any other potential cause first because PFOs are so common.”
Smith says the reason neurologists believe PFOs might be related to stroke risk is because in 50 percent of stroke cases where there is no other known cause, victims have been found to have a PFO. “The question is — should it be fixed?” Smith adds, noting that there is no significant clinical evidence showing that closure of this tiny hole in the heart reduces one’s risk of stroke.
That being said, it doesn’t mean Michaels’ surgery is unnecessary. Smith says the actor’s doctors likely took other factors into account before deciding to close the hole. “A lot of us have been skeptical that closing these holes is effective, but it’s an exceedingly safe procedure, and the risk of complications is very low.”
Essentially, a closure device is fitted into a delivery catheter, and then the catheter is inserted into a vein in the leg and advanced into the heart to close the opening. There is no open-heart surgery required.
So fans of the Poison singer need not be alarmed. “If you just randomly found you had a PFO and you hadn’t suffered a stroke,” says Smith, “my recommendation would be to do nothing.