Please Help..Second Opinion

I have written to you before under Patent Foramen Ovale Surgery and Right to Left Shunt and Can a hole in your heart cause tingling and numbness. I have been dx with  a PFO. No right to Left but blood flowing even at rest. MRI show multiple white dots frontal lobe mostly left few on right. radiologist probaly due to emboli crossing over, 2nd possibility MS. Get tingling and numbness in left side face, lip, tongue, arm and fingers sometimes left foot. Always left side. Here is my question.
My neuerologist feels I am at high risk for a stroke and feels the white dots are mini TIA's. Mri does not show infarct. She does not feel I have any symtoms (symptoms) of MS. She has strongly encouraged me to clsoe the hole. Cardiologist who was present at the echo with bubble contrast also strongly agrees. She sent me to cardiac surgeion. Trans cahter closure is not offered in HAWAII. He said he would not do a surgey to close the hole unless I have a stroke first. I was a little surprised to hear that since my other doctors are trying to prevent that from happening. He said there is a 1 chance in 100 I could die from the surgery, and I may neve have a stroke. Too risky. When I asked him about the transcahter method he said it is done on a experimental basis only. I told him I had read that it is done petty routinely here at your clinic, he said yes but it is stilland experiment, jsut keep taking your 2 aspirin a day and you'll be fine, come back after you have a stroke and well talk. Said he has done 4 surgeries recently for the same thing all young like me (43_) no other risk factors, and they had all had strokes, that warrant the risk of the surgey. He is very wll established and had done hundreds of surgeries, specializes in minimal invasive heart surgey.
WHERE DO I GO FROM HERE. THIS IS A HMO WITH KAISER BUT I ALSO HAVE REGULAR INSURANCE WHERE I COULD PROBALY COME TO THE MAIN

[Cleveland Clinic, MD]

A surgeon has the right to not operate on someone but I would agree with your other doctors that this does need closed.  Dr. Jonathan Drummond-Webb is the doctor placing them here. The Cleveland Clinic is a Kaiser HMO site so they may be willing to send you here. The closure devices are still experimental although many have been placed and it is probably just a matter of time before they are approved.  Surgical closure is the convential treatment.  You will have to work closely with your primary doctor to develop a treatment plan.  He should probably talk with Dr. Drummond-Webb and can contact his office through our toll-free number 800-CCF-CARE.  Best wishes and let us know how things turn out.

I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies.  Please feel free to write back with additional questions.

If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.  The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.