AUTHOR=Testa Luca , Popolo Rubbio Antonio , Squillace Mattia , Albano Flavio , Cesario Vincenzo , Casenghi Matteo , Tarantini Giuseppe , Pagnotta Paolo , Ielasi Alfonso , Popusoi Grigore , Paloscia Leonardo , Durante Alessandro , Maffeo Diego , Meucci Francesco , Valentini Giuliano , Ussia Gian Paolo , Cioffi Paolo , Cortese Bernardo , Sangiorgi Giuseppe , Contegiacomo Gaetano , Bedogni Francesco TITLE=Patent foramen ovale occlusion with the Cocoon PFO Occluder. The PROS-IT collaborative project JOURNAL=Frontiers in Cardiovascular Medicine VOLUME=9 YEAR=2023 URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.1064026 DOI=10.3389/fcvm.2022.1064026 ISSN=2297-055X ABSTRACT=Background

The Cocoon patent foramen ovale (PFO) Occluder is a new generation nitinol alloy double-disk device coated with nanoplatinum, likely useful in patients with nickel hypersensitivity. Early results and mid-term outcomes of this device in percutaneous PFO closure are missing.

Aims

To assess the preliminary efficacy and safety profile of PFO closure with Cocoon device in an Italian multi-center registry.

Methods

This is a prospective registry of 189 consecutive adult patients treated with the Cocoon PFO Occluder at 15 Italian centers from May 2017 till May 2020. Patients were followed up for 2 years.

Results

Closure of the PFO with Cocoon Occluder was carried out successfully in all patients, with complete closure without residual shunt in 94.7% of the patients and minimal shunt in 5.3%. Except from a case of paroxysmal supraventricular tachycardia and a major vascular bleeding, no procedural and in-hospital device-related complications occurred. No patient developed cardiac erosions, allergic reactions to nickel, or any other major complications during the follow-up. During the follow-up period, 2 cases of new-onset atrial fibrillation occurred within thirty-day.

Conclusions

Percutaneous closure of PFO with Cocoon Occluder provided satisfactory procedural and mid-term clinical follow-up results in a real-world registry.