My 52 y/o son had a middle cerebral artery syndrome (t.i.a.) 7 years ago attributed to transient factor 8 elevations (400%) which returned to normal (82%) in a few months. Work-up discovered a patent foramen ovale ( p.f.o.), no murmurs or cardiopulmonary symptoms.
He’s been on Coumadin ever since, no residual neurological symptoms and stable prothrombin times. He’s considering repair of the pfo,fully understanding its risks and that anticoagulation will still be necessary since the cause of the transient factor 8 elevation event remains unclear. Repair of the pfo should prevent another cerebral event since he’s never had atrial fibrillation/flutter and has no other risk factors for emboli except history of hypercoagulopathy, ?idiopathic.