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Prospective evaluation of the feasibility, safety, and efficacy of Cocoon Duct Occluder for transcatheter closure of large patent ductus arteriosus: A single-center study with short- and medium-term follow-up results [Anatol J Cardiol]
Anatol J Cardiol. 2017; 18(5): 321-327 | DOI: 10.14744/AnatolJCardiol.2017.7814  

Prospective evaluation of the feasibility, safety, and efficacy of Cocoon Duct Occluder for transcatheter closure of large patent ductus arteriosus: A single-center study with short- and medium-term follow-up results

Santosh Kumar Sinha, Mahmadula Razi, Rama Niwas Pandey, Prakash Kumar, Vinay Krishna, Mukesh Jitendra Jha, Vikas Mishra, Mohammad Asif, Nasar Abdali, Pradyot Tewari, Ramesh Thakur, Umeshwar Pandey, Chandra Mohan Varma
Department of Cardiology, LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, Uttar Pradesh-India

Objective: To evaluate the feasibility, safety, and efficacy of a novel Cocoon Duct Occluder device for the transcatheter closure (TCC) of large patent ductus arteriosus (PDA).
Methods: In this prospective, non-randomized study, consecutive patients with large PDA (narrowest diameter: ≥3.5/4.0 mm in symptomatic/asymptomatic patients, respectively), who underwent TCC with Cocoon Duct Occluder at our institute between November, 2012 and June, 2016 were examined. TCC was performed using the standard technique, and devices were antegradely delivered via 610F delivery sheaths. Device embolization, residual shunt, hemolysis, left pulmonary artery (LPA) stenosis, procedural and fluoroscopy time, and mortality were assessed. Patients were followed-up by transthoracic echocardiography with color Doppler imaging at 24 h (D1), 1 month (D30), and 6 months (D180) after implantation.
Results: A total of 57 patients (age: 11.72.8 years; weight: 22.33.5 kg) were enrolled. The mean narrowest diameter was 7.40.7 mm. The PDA closure was successfully performed in each patient. Fluoroscopy and procedural time was 6.73.2 min and 23.92.7 min, respectively. Postprocedural angiography revealed that 49 (85.9%) patients had immediate and complete closure, whereas 8 (14.1%) had residual shunt. Color Doppler imaging at D1 revealed complete closure in 52 (91.3%) patients. At D30, complete closure was reported in all patients and was maintained at D180. Hemolysis, embolization, obstruction of LPA or descending aorta, and death were not reported till D180.
Conclusion: TCC using Cocoon Duct Occluder is feasible, safe, and effective in the management of patients with large PDA, with excellent results on short- and medium-term follow-up.

Keywords: congenital heart disease, transcatheter closure, Cocoon Duct Occluder, large patent ductus arteriosus


Santosh Kumar Sinha, Mahmadula Razi, Rama Niwas Pandey, Prakash Kumar, Vinay Krishna, Mukesh Jitendra Jha, Vikas Mishra, Mohammad Asif, Nasar Abdali, Pradyot Tewari, Ramesh Thakur, Umeshwar Pandey, Chandra Mohan Varma. Prospective evaluation of the feasibility, safety, and efficacy of Cocoon Duct Occluder for transcatheter closure of large patent ductus arteriosus: A single-center study with short- and medium-term follow-up results. Anatol J Cardiol. 2017; 18(5): 321-327

Corresponding Author: Santosh Kumar Sinha


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