As medical research continues to advance, the benefits and risks associated with some surgeries can lead to a vigorous debate about the necessity of these procedures. This particularly holds true for patent foramen ovale (PFO) closure, a surgery that closes a hole in the heart wall that didn't close properly after birth. Although it's not uncommon to have a PFO, most people with the condition never know they have it, and never require any treatment. So when Laura Holland's doctor discovered a PFO in her heart and recommended surgery to close it, Laura was uncertain if that was the right option for her situation. She reached out to Cleveland Clinic's MyConsult® Online Medical Second Opinion program to seek some expert advice.
Laura, 61, a resident of Aurora, New York, says she has always been considered an extremely healthy person. So it came as quite a shock when she suffered one stroke in February of 2010, followed by a second stroke in September of 2015. "After my first stroke, my care team in New York discovered that I had a PFO and believed it could have been the source of the blood clot," she says. "So I was advised to have surgery to close it. However, I didn't feel comfortable with having the procedure because there is a lot of debate about the effectiveness of PFO surgery, and if it can actually help prevent additional strokes. So I put it off. When I had the second stroke on Labor Day weekend last year despite taking Aspirin regularly, it put me into a whole different risk category and I was strongly advised to move forward with the surgery."
Understandably conflicted, Laura did extensive research to determine if PFO surgery was the right choice. Knowing that Cleveland Clinic is ranked number one in the United States for cardiology and heart surgery, she looked into the available research from our organization about the topic. "I found an article in the Cleveland Clinic Journal of Medicine that discussed the highly debated nature of PFO closure for the purpose of preventing strokes," she says. "I had actually already made an appointment to have it closed, and then cancelled the appointment because of this article. Instead, I decided to go to Cleveland Clinic to see what they had to say about my unique situation. When I called to make the appointment, the representative I spoke to told me about the MyConsult® program, which seemed like a great option to start the process of getting second opinion online from Cleveland Clinic's heart experts without having to travel.
Cleveland Clinic's MyConsult® Online Medical Second Opinion program is a sophisticated, Web-based extension of Cleveland Clinic's 90-plus-year role as one of America's most respected referral institutions. The secure, online program provides medical second opinions from Cleveland Clinic specialists for more than 1,200 life-threatening and life-changing diagnoses.
Once Laura had gathered all of the necessary medical information, she sent it to Cleveland Clinic where it was triaged by the MyConsult® Clinical Operations Center nursing team and forwarded for review to Dr. Robert Stewart in the Department of Thoracic and Cardiovascular Surgery. Laura says she was impressed with how quickly Dr. Stewart was able to reply. "I had made up my mind when I decided to pursue this route that I would do whatever Dr. Stewart advised me to do," she says. "When I read through his report it was very satisfying to me in that he addressed my specific circumstances and if this surgery was right for me. He was able to clearly explain why I should have the surgery done. His recommendations addressed me personally and answered my personal questions, as opposed to telling me what happened in some study."
So Laura decided to have the PFO closure, as was recommended by her care team in New York and confirmed by Dr. Stewart's MyConsult® report. She opted to have the surgery in New York, as Dr. Stewart had advised that any major medical center should be able to successfully perform the operation. It has been just a few months since Laura's surgery and she says she is already feeling great. "No one should ever go into elective surgery feeling unsure about what they're doing. Although there's no way to definitively say that this is going to prevent me from having another stroke, I do feel absolutely sure that I made the right decision for me," she concludes. "Dr. Stewart's MyConsult® Online Medical Second Opinion report gave me the confidence I needed to go forward. I'd absolutely recommend the service to anyone who may be questioning the best course of action for a serious medical decision."