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Impact of Patent Foramen Ovale Closure on the Frequency of Migraine: Waikato Hospital Experience
S35
Abstracts
0.41 (0.30-0.56; p < 0.001); valve related mortality 0.23 (0.140.37; p < 0.001); re-operation 3.02 (1.72-5.31; p < 0.001); and bleeding 0.26 (0.11-0.63; p = 0.003). There was a trend towards lower thromboembolism 0.42 (0.17-1.03; p = 0.06) and no significant difference in endocarditis (p = 0.76) rates during follow-up. Conclusion: Mitral valve repair is associated with reduction in operative and long-term mortality and bleeding, so is recommended to be performed in rheumatic mitral valve disease where feasible, although it does have higher rates of re-operations during follow-up.
Of the 188 patients who underwent TAVI 147 were transfemoral, 17 transapical and 24 transaortic. Survival was similar between TAVI and SAVR with both longer than medical therapy p = 0.002 (93, 84 and 73% at one year and 85, 84 and 54% at two years respectively). Outcomes from TAVI and SAVR were similar to the general population. Conclusion: Mean survival of aortic stenosis patients who receive TAVI and SAVR is similar to the general population and longer than those who receive medical therapy alone. A decrease in mean EuroSCORE II over time in patients undergoing aortic valve interventions was observed.
http://dx.doi.org/10.1016/j.hlc.2017.05.089
http://dx.doi.org/10.1016/j.hlc.2017.05.092
P55
P58
Abstract withdrawn
Impact of Patent Foramen Ovale Closure on the Frequency of Migraine: Waikato Hospital Experience
http://dx.doi.org/10.1016/j.hlc.2017.05.090 P56
Pavan Thaneeru 1*, Alexander Sebastian 2, Rajesh Nair 1, Sanjeevan Pasupati 1 1
Abstract withdrawn http://dx.doi.org/10.1016/j.hlc.2017.05.091 P57 Characteristics and Outcomes of Patients with Aortic Stenosis Discussed by the Multidisciplinary “Heart Team” According to Treatment Allocation Conor Rea *, Peter Ruygrok, Karishma Sidhu, Tom Kai Ming Wang, Tharumenthiran Ramanathan, Parma Nand, Jim Stewart, Mark Webster Cardiology Department, Auckland City Hospital, Auckland, New Zealand * Corresponding author. Background: Transcatheter aortic valve implantation (TAVI) was introduced to Auckland City Hospital in 2011 for patients at high risk of mortality and morbidity from surgical aortic valve replacement (SAVR), as assessed by a multidisciplinary “Heart Team” (MHT). Aim: To establish the characteristics, outcomes and survival of aortic stenosis patients according to treatment allocation by the MHT. Method: Demographic and clinical information of all patients discussed by the MHT was obtained from hospital records and the National Mortality Collection. The EuroSCORE II was calculated and survival curves constructed. Results: Between June 2011 and August 2016 243 patients (mean age 80.2 years, 60% male) were presented at the MHT meeting. TAVI was recommended for 200, SAVR for 26 and medical therapy for 17 patients, with no significant difference in mean age (80.2, 80.4, 80.4, respectively) or EuroSCORE II (6.5, 5.3, and 6.7, respectively) between groups. Those selected for TAVI had consistently higher mean EuroSCORE II than SAVR. Unlike mean age, EuroSCORE II showed a significant decrease over time (TAVI p = 0.026, SAVR p = 0.004).
Waikato Hospital, Hamilton, New Zealand University of Leeds School of Medicine, United Kingdom * Corresponding author. 2
Introduction: The association of patent foramen ovale (PFO) and migraine remains unclear. Aim: To determine the long-term effect of percutaneous closure of patent foramen ovale (PFO) defects on the incidence and frequency of migraine. Methods: This was a retrospective telephone survey in consecutive patients who underwent percutaneous PFO closure at Waikato hospital. The frequency of migraine before and after PFO closure was noted. Results: 53 procedures were done on 50 patients. Indication for PFO closure was stroke (94%), peripheral embolisation (2%), barotrauma (2%) and postoperative desaturation (2%). 56% patients were male and average age was 46 years. 98% of patients had a successful PFO closure with 6% closed at the second attempt and 1(2%) closed surgically. In 1 patient PFO was purposefully left unclosed. Bubble study at 6 months was done in 92% of patients. In 87% of patients complete closure were observed. There were no device migration, erosion or thrombus noted. At the follow-up period of 1337 785days, 47 patients had telephone interview. 14 (30%) patients had an incidental history of migraine before the PFO closure. 50% reported a complete resolution of migraine with 1 new onset migraine post PFO closure. 87% reported a reduction of migraine episodes per week after PFO closure (P = 0.04). Before PFO closure
After PFO closure
P
Migraine n (%)
14 (30%)
8 (17%)
0.22
Average Migraine
45
6
0.04
episodes per week
Conclusion: Closure of PFO shows a strong association with reduction in migraine frequency. http://dx.doi.org/10.1016/j.hlc.2017.05.093
Abstracts
0.41 (0.30-0.56; p < 0.001); valve related mortality 0.23 (0.140.37; p < 0.001); re-operation 3.02 (1.72-5.31; p < 0.001); and bleeding 0.26 (0.11-0.63; p = 0.003). There was a trend towards lower thromboembolism 0.42 (0.17-1.03; p = 0.06) and no significant difference in endocarditis (p = 0.76) rates during follow-up. Conclusion: Mitral valve repair is associated with reduction in operative and long-term mortality and bleeding, so is recommended to be performed in rheumatic mitral valve disease where feasible, although it does have higher rates of re-operations during follow-up.
Of the 188 patients who underwent TAVI 147 were transfemoral, 17 transapical and 24 transaortic. Survival was similar between TAVI and SAVR with both longer than medical therapy p = 0.002 (93, 84 and 73% at one year and 85, 84 and 54% at two years respectively). Outcomes from TAVI and SAVR were similar to the general population. Conclusion: Mean survival of aortic stenosis patients who receive TAVI and SAVR is similar to the general population and longer than those who receive medical therapy alone. A decrease in mean EuroSCORE II over time in patients undergoing aortic valve interventions was observed.
http://dx.doi.org/10.1016/j.hlc.2017.05.089
http://dx.doi.org/10.1016/j.hlc.2017.05.092
P55
P58
Abstract withdrawn
Impact of Patent Foramen Ovale Closure on the Frequency of Migraine: Waikato Hospital Experience
http://dx.doi.org/10.1016/j.hlc.2017.05.090 P56
Pavan Thaneeru 1*, Alexander Sebastian 2, Rajesh Nair 1, Sanjeevan Pasupati 1 1
Abstract withdrawn http://dx.doi.org/10.1016/j.hlc.2017.05.091 P57 Characteristics and Outcomes of Patients with Aortic Stenosis Discussed by the Multidisciplinary “Heart Team” According to Treatment Allocation Conor Rea *, Peter Ruygrok, Karishma Sidhu, Tom Kai Ming Wang, Tharumenthiran Ramanathan, Parma Nand, Jim Stewart, Mark Webster Cardiology Department, Auckland City Hospital, Auckland, New Zealand * Corresponding author. Background: Transcatheter aortic valve implantation (TAVI) was introduced to Auckland City Hospital in 2011 for patients at high risk of mortality and morbidity from surgical aortic valve replacement (SAVR), as assessed by a multidisciplinary “Heart Team” (MHT). Aim: To establish the characteristics, outcomes and survival of aortic stenosis patients according to treatment allocation by the MHT. Method: Demographic and clinical information of all patients discussed by the MHT was obtained from hospital records and the National Mortality Collection. The EuroSCORE II was calculated and survival curves constructed. Results: Between June 2011 and August 2016 243 patients (mean age 80.2 years, 60% male) were presented at the MHT meeting. TAVI was recommended for 200, SAVR for 26 and medical therapy for 17 patients, with no significant difference in mean age (80.2, 80.4, 80.4, respectively) or EuroSCORE II (6.5, 5.3, and 6.7, respectively) between groups. Those selected for TAVI had consistently higher mean EuroSCORE II than SAVR. Unlike mean age, EuroSCORE II showed a significant decrease over time (TAVI p = 0.026, SAVR p = 0.004).
Waikato Hospital, Hamilton, New Zealand University of Leeds School of Medicine, United Kingdom * Corresponding author. 2
Introduction: The association of patent foramen ovale (PFO) and migraine remains unclear. Aim: To determine the long-term effect of percutaneous closure of patent foramen ovale (PFO) defects on the incidence and frequency of migraine. Methods: This was a retrospective telephone survey in consecutive patients who underwent percutaneous PFO closure at Waikato hospital. The frequency of migraine before and after PFO closure was noted. Results: 53 procedures were done on 50 patients. Indication for PFO closure was stroke (94%), peripheral embolisation (2%), barotrauma (2%) and postoperative desaturation (2%). 56% patients were male and average age was 46 years. 98% of patients had a successful PFO closure with 6% closed at the second attempt and 1(2%) closed surgically. In 1 patient PFO was purposefully left unclosed. Bubble study at 6 months was done in 92% of patients. In 87% of patients complete closure were observed. There were no device migration, erosion or thrombus noted. At the follow-up period of 1337 785days, 47 patients had telephone interview. 14 (30%) patients had an incidental history of migraine before the PFO closure. 50% reported a complete resolution of migraine with 1 new onset migraine post PFO closure. 87% reported a reduction of migraine episodes per week after PFO closure (P = 0.04). Before PFO closure
After PFO closure
P
Migraine n (%)
14 (30%)
8 (17%)
0.22
Average Migraine
45
6
0.04
episodes per week
Conclusion: Closure of PFO shows a strong association with reduction in migraine frequency. http://dx.doi.org/10.1016/j.hlc.2017.05.093