Study Aims to Determine Whether Closing a Hole in the Heart May Lead to Migraine Headache Relief

Libraries Medical News   Keywords MIGRAINES, HEACHACHES, HEART, RUSH UNIVERSITY MEDICAL CENTER, PFO Contact Information Available for logged-in reporters only Description Interventional cardiologists at Rush University Medical Center are investigating whether a heart procedure may be the key to relieving migraines in patients with severe headaches.

Newswise �?Interventional cardiologists at Rush University Medical Centerare investigating whether a heart procedure may be the key to relieving migraines in patients with severe headaches.

Earlier studies have indicated that there may be a link between a particular congenital heart anomaly, a patent foramen ovale (PFO), and migraine. Some patients �?particularly those suffering from migraine with aura- have had reductions in the frequency and severity of migraines following closure of their PFO. In the Rush study, interventional cardiologists will close the PFO in the catheterization lab using an implant that acts like an umbrella, crossing over the chambers in attempt to occlude or close the flaps together.

Principal investigator Dr. Clifford Kavinsky and his team have started enrolling patients for the clinical trial, called MIST II (Migraine Intervention with BioSTAR). The team is looking for individuals with severe migraines to see if they may have a patent foramen ovale.

A PFO is a small opening between two overlapping sections of tissue which form a division between the upper chambers of the heart, the right atrium and the left atrium. In the womb, this opening is present since it makes circulation more efficient for the developing fetus. After birth, the flaps normally fuse together to form a solid wall, called a septum, between the chambers. However, in about 25 percent of the population, the flaps do not fuse together.

The PFO then works like a valve, staying closed most of the time but opening when certain activities cause a build up of pressure inside the chest. When opened, the PFO may permit unfiltered venous blood to cross from the right atrium to the left atrium rather than passing through the lungs. The unfiltered venous blood may contain elements that can trigger migraines in some patients.

“In a smaller predicate trial of similar design conducted in the United Kingdom , headache specialists observed a significant treatment effect with 42 percent of patients experiencing a 50 percent reduction in migraine headache days and 37 percent reduction in frequency and duration of migraine attacks,�?says Kavinsky. “The combination of the bioabsorbable septal repair implant and the longer duration of the MIST II Trial are expected to provide even more positive outcomes. Finding an effective therapy for this group of patients who are refractory to medical therapy would be an important advance in the treatment of migraine.�?/FONT>