Tuesday, October 31, 2006
Should PFOs be sealed?
The medical device makers certainly hope so, they have lots of profit at stake. Patriots linebacker Tedy Bruschi had his sealed, chronicled here extensively.
Posted by Kevin |
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Comments:
The intervention is not without some complications; neurologic injury, vascular injury to the leg, and even death do occur with closure of the PFO even by the newer lesser invasive techniques cardiologists can now perform.
'Fixing' the anatomic problem for 50 million americans (1 billion people world wide) would require our entire economy to double the size of the health care establishment to consume a full third of our entire economy. Obveously there are many with much to gain and don't see this as a negative.
From a total burden of disease, PFO is low; most people with PFO make it their entire life without any complications resulting. While it is great that the treatment has become safer compared with open heart surgery, this does not mean that we should necessarily treat more people. Evidence based guidelines are needed here. We are awaiting the results of some real clinical trials regarding the prophylactic use of PFO closure. In their rush to apply their new tool, cardiologists are unfortunately skipping enrolling patients into trials in favor of providing unproven therapies.
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'Fixing' the anatomic problem for 50 million americans (1 billion people world wide) would require our entire economy to double the size of the health care establishment to consume a full third of our entire economy. Obveously there are many with much to gain and don't see this as a negative.
From a total burden of disease, PFO is low; most people with PFO make it their entire life without any complications resulting. While it is great that the treatment has become safer compared with open heart surgery, this does not mean that we should necessarily treat more people. Evidence based guidelines are needed here. We are awaiting the results of some real clinical trials regarding the prophylactic use of PFO closure. In their rush to apply their new tool, cardiologists are unfortunately skipping enrolling patients into trials in favor of providing unproven therapies.
