Safety and Feasibility of Transcatheter Interruption of Ruptured Sinus of Valsalva Aneurysm Using the Cocoon Duct Occluder: Immediate Results and Mid-Term Follow-Up

BACKGROUND: Limited data are available regarding safety and feasibility of transcatheter interruption of ruptured sinus of Valsalva aneurysm (RSOVA) using the Cocoon duct occluder (CDO) with immediate and mid-term follow-up result. METHODS: Transcatheter closure (TCC) was successfully done among eight patients, whereas five cases, not amenable to TCC, were referred for surgical correction among 13 consecutive patients of RSOVA at LPS Institute of Cardiology, Kanpur between January 2010 and March 2015. RESULTS: Their mean age was 26.1 ± 6.9 years. Sites of rupture were from right coronary sinus (RCS) to right atrium (RA) in one (12.5%), right ventricle in one (12.5%), and non-coronary sinus to RA in six patients (75%). The defects (9 - 17 mm) were closed by CDO (12/10 - 20/18 mm) with 100% procedural success. During follow-up (9 - 26 months), there was no residual shunt, progression of AR, infective endocarditis or device embolization. CONCLUSION: TCC of RSOVA appears to be a safe and feasible alternative to surgical therapy, with high technical success and excellent mid-term follow-up.