Transcatheter PFO Closure in an Aircrew Member with Cryptogenic Stroke: Aeromedical Disposition
Johnson EG, McCrary BF, Kruyer WB. Transcatheter PFO closure in an aircrew member with cryptogenic stroke: aeromedical disposition. Aviat Space Environ Med 2004; 75:180–183.
Stroke is an uncommon event among military aircrew, partly because that population tends to be younger and healthier than typical stroke victims. Aircrew members suffering stroke rarely have identifiable risk factors or etiology that can be treated or modified such that return to flying duties is a consideration. In this case, an aircrew member was found to have a patent foramen ovale (PFO) during his stroke evaluation. Several studies support the association between PFO and cryptogenic stroke, but literature clearly defining the need for PFO repair in the context of cryptogenic stroke is still incomplete. On clinical recommendation from his providers, this aircrew member underwent elective closure of his PFO with a transcatheter device. After complete recovery from his stroke and an apparently successful PFO closure, he requested return to flying duties. History of stroke and PFO closure with transcatheter device were both disqualifying conditions according to United States Air Force Instructions. This case is presented as an example of an aeromedical decision-making process when confronted with an unusual case such as this.
Stroke is an uncommon event among military aircrew, partly because that population tends to be younger and healthier than typical stroke victims. Aircrew members suffering stroke rarely have identifiable risk factors or etiology that can be treated or modified such that return to flying duties is a consideration. In this case, an aircrew member was found to have a patent foramen ovale (PFO) during his stroke evaluation. Several studies support the association between PFO and cryptogenic stroke, but literature clearly defining the need for PFO repair in the context of cryptogenic stroke is still incomplete. On clinical recommendation from his providers, this aircrew member underwent elective closure of his PFO with a transcatheter device. After complete recovery from his stroke and an apparently successful PFO closure, he requested return to flying duties. History of stroke and PFO closure with transcatheter device were both disqualifying conditions according to United States Air Force Instructions. This case is presented as an example of an aeromedical decision-making process when confronted with an unusual case such as this.
Keywords: cryptogenic stroke; patent foramen ovale; transcatheter device
Document Type: Research Article
Publication date: 01 February 2004
- The peer-reviewed monthly journal, Aviation, Space, and Environmental Medicine (ASEM) provides contact with physicians, life scientists, bioengineers, and medical specialists working in both basic medical research and in its clinical applications. It is the most used and cited journal in its field. ASEM is distributed to more than 80 nations.
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