Transcatheter closure of patent foramen ovale using the Cocoon occluder: A multicenter retrospective study.

Device Heart defects Implants Patent foramen ovale

Journal

Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese
ISSN: 2241-5955
Titre abrégé: Hellenic J Cardiol
Pays: Netherlands
ID NLM: 101257381

Informations de publication

Date de publication:
29 Apr 2023
Historique:
received: 05 01 2023
revised: 28 03 2023
accepted: 28 04 2023
pubmed: 2 5 2023
medline: 2 5 2023
entrez: 1 5 2023
Statut: aheadofprint

Résumé

The Cocoon patent foramen ovale (PFO) occluder is a new device especially designed for transcatheter closure of PFO. This occluder has some distinctive structural modifications aimed at reducing the risk of major complications of transcatheter PFO closure. In this report we present our initial experience to evaluate the efficacy and safety of the Cocoon PFO occluder in 253 patients who underwent transcatheter PFO closure. The study cohort included 253 patients (median age 45 years) with embolic stroke of undetermined source who underwent attempted transcatheter closure of PFO for secondary prevention of paradoxical embolism. Patients were enrolled retrospectively from five sites in Greece and one in Romania between December 2016 and January 2021, and the median follow-up period was 28 months (range 12-48 months). Clinical and laboratory data from each participating center were sent to an electronic registry for evaluation and statistical analysis. The Cocoon PFO occluder was permanently implanted in all patients. At 6 months, complete occlusion of PFO was observed in 251/253 (99.2%) patients. Three (1.2%) patients had a trivial residual shunt. Thrombus formation on the device, which was successfully treated with recombinant tissue plasminogen activator infusion, was observed in one (0.4%) patient. No other complications occurred. During a median follow-up period of 28 months, 3 (1.2%) patients, aged 64-67 years, developed new onset paroxysmal atrial fibrillation. No neurologic events, cardiac erosions, allergic reactions to nickel, or thrombus formation occurred. The Cocoon PFO occluder is an effective and safe device that adds to our armamentarium for transcatheter closure of PFO.

Sections du résumé

BACKGROUND BACKGROUND
The Cocoon patent foramen ovale (PFO) occluder is a new device especially designed for transcatheter closure of PFO. This occluder has some distinctive structural modifications aimed at reducing the risk of major complications of transcatheter PFO closure. In this report we present our initial experience to evaluate the efficacy and safety of the Cocoon PFO occluder in 253 patients who underwent transcatheter PFO closure.
METHODS METHODS
The study cohort included 253 patients (median age 45 years) with embolic stroke of undetermined source who underwent attempted transcatheter closure of PFO for secondary prevention of paradoxical embolism. Patients were enrolled retrospectively from five sites in Greece and one in Romania between December 2016 and January 2021, and the median follow-up period was 28 months (range 12-48 months). Clinical and laboratory data from each participating center were sent to an electronic registry for evaluation and statistical analysis.
RESULTS RESULTS
The Cocoon PFO occluder was permanently implanted in all patients. At 6 months, complete occlusion of PFO was observed in 251/253 (99.2%) patients. Three (1.2%) patients had a trivial residual shunt. Thrombus formation on the device, which was successfully treated with recombinant tissue plasminogen activator infusion, was observed in one (0.4%) patient. No other complications occurred. During a median follow-up period of 28 months, 3 (1.2%) patients, aged 64-67 years, developed new onset paroxysmal atrial fibrillation. No neurologic events, cardiac erosions, allergic reactions to nickel, or thrombus formation occurred.
CONCLUSION CONCLUSIONS
The Cocoon PFO occluder is an effective and safe device that adds to our armamentarium for transcatheter closure of PFO.

Identifiants

pubmed: 37127207
pii: S1109-9666(23)00067-2
doi: 10.1016/j.hjc.2023.04.011
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2023 Hellenic Society of Cardiology. Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest None.

Auteurs

Basil Vasileios D Thanopoulos (BVD)

Department of Cardiology, IASO Children's Hospital, Marousi, Greece. Electronic address: vthanop@otenet.gr.

Georgios C Bompotis (GC)

Department of Cardiology, Papageorgiou General Hospital, Thessaloniki, Greece.

Dan Deleanou (D)

Department of Cardiology, Institute for Cardiovascular Diseases, C.C. Iliescu Bucharest, Romania.

Petros Dardas (P)

Department of Cardiology, Saint Lucε Hospital S.A. Thessaloniki, Greece.

Vlasis Ninios (V)

Department of Cardiology Interbalcan Medical Center, Thessaloniki, Greece.

George S Tsaousis (GS)

Department of Cardiology, IASO Children's Hospital, Marousi, Greece.

Athanasios Trikas (A)

Department of Cardiology Elpis General Hospital, Athens, Greece.

Vasileios Saxpekidis (V)

Department of Cardiology, Papageorgiou General Hospital, Thessaloniki, Greece.

Classifications MeSH