Closing a Heart Hole May Help Migraines
Study Shows Migraine Relief After Fixing a Heart Abnormality Called PFO
Feb. 16, 2009 -- Can closing a hole in the heart be an effective treatment
New research suggests that it may for migraine sufferers with a common heart
abnormality known as a patent foramen ovale (PFO).
But a researcher who has studied the issue for almost a decade tells WebMD
that the jury is still out on the treatment.
In the new study, patients with PFOs who had a minimally invasive
catheter-based procedure to close the small hole in their heart had
significantly fewer disabling migraines than patients with PFOs who did not
have the procedure.
Migraines and PFO Closure
As many as one in four people have a PFO abnormality, but most never know
Prior to birth, everyone has the small opening, which exists to divert blood
away from undeveloped lungs. Normally, the hole closes after birth, but in some
people the closure is not complete.
While not everyone with PFOs has migraines and not everyone with migraines
has PFOs, studies show that migraine sufferers are far more likely to have the
heart abnormality than people without migraines.
PFO researcher Peter Wilmshurst, MB, of the UK's Royal Shrewsbury Hospital,
tells WebMD that about half of patients with a specific type of migraine known
as migraine with aura have large PFOs or similar openings in their hearts
compared to about 5% of the population at large.
Wilmshurst did not participate in the new study, but he was involved in an
earlier study that examined PFO closure as a treatment for migraines. Published
last year, that study, known as the MIST trial, found no benefit for the
The new study included 82 migraine patients who had large PFOs and no
history of strokes. All the patients also had a type of brain lesion that is
commonly seen in brain scans of patients with migraines.
Fifty-three of the patients had the PFO closure procedure and 29 did
At six months follow-up, the PFO closure patients showed significant
improvements in both the frequency and severity of their migraine
In all, 53% of patients in the PFO closure group reported a disappearance of
disabling headaches, compared to 7% of the patients who did not have the
closure procedure; 87% in the closure group reported a more than 50% reduction
in total headaches, compared to 21% of the patients in the comparison
The study appears in the Feb. 24 issue of the Journal of the American
College of Cardiology.
"Only patients in the closure group reported a significant reduction of
migraine severity, which is crucial for quality of life," study researcher
Carlo Vigna, MD, and colleagues write. "In contrast, the number of
disabling attacks did not change or increased in 41% of controls."