AU professor Dr. Jeff Vallance is filling gaps in research after experiencing a stroke caused by a hole in his heart
As a healthy adult—especially as a non-smoker, runner, and health researcher—a stroke was one of the last things Dr. Jeff Valance expected.
However, at age 42, Vallance, a professor in the Faculty of Health Disciplines at Athabasca University (AU), had a stroke while out for a Sunday-morning run.
“The whole right side of your body shuts down and you have slurred speech and tingling feeling in your limbs and your lips… so I knew right away that I was having a stroke,” he said.
Only about two kilometres from home, Vallance was able to make his way back and get to the hospital. After extensive testing, doctors discovered it was an ischemic stroke, caused when a blood clot blocks an artery that supplies blood to the brain.
After further testing, they discovered the stroke was due to a congenital hole between the left and right atria of the heart found in 25% of the population, called a patent foramen ovale (PFO). It is estimated that 5% of all strokes may be due to PFO (i.e., PFO-associated stroke).
A PFO lets small blood clots slip through and travel up to the brain where a stroke can happen. Typically, these strokes happen in younger people with no other risk factors for stroke. Among patients with a cryptogenic stroke, a PFO is detected in roughly 40%–50% people, according to the Mayo Clinic.
“Lots of people have small blood clots floating through their body, but they go into the heart and then they go into the lungs where those blood clots are filtered out and reabsorbed into the body,” said Vallance.
“If you have that hole in between the right and the left atrium, a blood clot can slip through to the left side of the heart, usually during exertion, and from there it goes directly up to the brain and that's where a clot can potentially lodge into the arteries and cause a stroke.”
According to Vallance, everyone is born with a PFO, but in their first year of life, the hole gradually closes. In 25% of people however, it doesn’t close fully. Normally a PFO doesn’t cause any significant issues and most people don’t even know they have one.
Vallance said he learned he had a PFO in his heart as a graduate student in exercise sciences at the University of Alberta, but thought nothing of it.
“I didn't know that it could possibly cause a stroke 25 years later in my life,” he said.
Recovery and research
About a year after his stroke, surgeons closed the hole in his heart with a small umbrella-like device in a procedure called transcatheter closure. Over time the heart tissue, which is a muscle, grows over the device, Vallance explained.
“If you were to image my heart right now, you wouldn't even see it there. You would just see normal heart tissue,” he said.
An avid runner, Vallance was keen to get back to physical activity. But with the added complication of experiencing a PFO-associated stroke, he needed to know how much exercise was safe—before and after surgery.
To his surprise, there was no literature on the topic. His health-care team had no guidelines or suggestions on how to get back to being active. His scholarly searches on returning to activity after a PFO-associated stroke came up empty.
“There are actual clinical guidelines for returning to exercise after you've had a normal stroke. But for this type of stroke, you have the heart involved and you have a device in your heart now as well. That changes things,” said Vallance.
“There was absolutely no research on physical activity after PFO-associated stroke…which is surprising as there are unique circumstances when returning to activity that are different than the general stroke survivor population.”
Conducting his own study
Vallance knew he had to take matters into his own hands. In 2023, he published an open-access call to action for research in this area.“Probably once a week someone emails me saying they had the same type of stroke, and [are looking for] recommendations on exercise. I’ve had close to 100 people from all over the world reach out to me…it just really shows the lack of information out there.”
In 2025, Vallance and his team interviewed a global sample of 48 PFO stroke survivors to learn more. In August 2026, Vallance and fellow AU professor Dr. Lynn Corcoran published Patient perceptions of physical activity after patent foramen ovale (PFO)-associated stroke and transcatheter closure: A qualitative study, an open-source paper in the journal PLoS One.
It is the first published data on the topic.
His research found three main themes related to how patients feel about physical activity after having a PFO-associated stroke and transcatheter closure.
They found participants faced psychological barriers like: fear, anxiety, and closure-device apprehension; variability in fitness performance including a decline in physical activity; and variability in physical recovery—some with lingering fatigue, residual physical symptoms, and cardiac irregularities post-surgery.
Having experienced this first-hand, Vallance understood the anxiety and uncertainty associated with trying to get back to doing regular physical activity after a stroke. His data showed that there is a lot of anxiety around the closure procedure as well.
“As you can see in our data there, so many people are worried about having a device in their heart,” he said.
Anxiety after a PFO-associated stoke
His research showed that psychological barriers were consistently mentioned as important factors in the process of returning to physical activity. Participants also expressed anxiety and fear about over-exerting themselves and having another stroke—both while waiting for transcatheter closure and after the procedure.
“A lot of people are worried if they exercise too soon that it's going to come loose or it's going to break. That device is in there and it's in there for good, but it seems that’s not being communicated clearly,” Vallance said.
“The rate of complication in these devices is around less than 1% and that's typically not from the device breaking free or breaking loose.”
According to Vallance, one of the most significant take-aways from this research is that the biggest obstacle might be psychological, rather than physical. People who have a PFO-associated stroke are typically younger—the data from his research showed 44 was the mean age of people when they had their PFO-related stroke.
“There's a lot of psychological implications of having that type of stroke when you're young, finding out you have a hole in your heart, having a corrective procedure and putting something into your heart, and then you're expected to just get back out there and do everything that you were doing before,” he said.
“Without the proper guidance or the proper communication to help you…there’s just a large thirst for that knowledge.”
A lot of people are worried if they exercise too soon that it's going to come loose or it's going to break. That device is in there and it's in there for good, but it seems that’s not being communicated clearly.
Using data to provide clarity
Vallance anticipates that their data will eventually show that people can quickly get back to what they were doing before their PFO-related stroke.He said the bigger concern will be for those who haven't been active for six to eight months while waiting for the closure procedure, and then jumping back into training for a marathon after closure.
“You're probably more likely to have an adverse event in terms of an injury [like] tweaking your knee just because you're relatively deconditioned. So there's still merit in taking that approach where, you know, take it easy, build yourself back up, but by and large, having this type of device in your heart shouldn't slow you down.”
Vallance, for example, returned to running ultra-marathons (over 50 kilometres on more rugged terrain) seven months after his closure procedure, and about one-and-a-half years after his stroke.
“I felt fitter and healthier than I ever have before my stroke because my PFO was quite large, so after closure the blood was now going to where it was supposed to go” he said.
“It's kind of a blessing in disguise, you know, you go through a stroke, but when you get through it, for me there were many positives at the end of the journey as well.”
Vallance’s second study focusing on the physical activity advice patients received from their healthcare team is currently under review at a peer-reviewed open-access medical journal.