Patent ductus arteriosus (PDA), a persistent left to right shunt at great arterial level, accounts up to 10% of all congenital heart disease. Here, we report a case of a 6-month old baby with large PDA (5mm) whose percutaneous closure was planned. The Coccoon Duct Occluder (CDO) - 8/6 was fitted by rotating it clockwise over the delivery cable and the assembly of loader-cable-device was advanced into the descending aorta. The device was properly positioned across the PDA as both the aortic, and pulmonic side of the devise was properly opened. The device was then released by turning the delivery cable counter-clockwise using the pin vise, but inadvertently the delivery sheath remained attached to the pulmonic side of the device. All efforts to rescrew the delivery cable to the device failed. The delivery sheath was gently rotated counter-clockwise over the device to detach it successfully from the pulmonic end of the device, thereby securing its perfect placement. Aortogram using the pigtail catheter confirmed its perfect position with no residual shunt. Therefore, delivery sheath should be pulled fair enough proximal to the pulmonic end of the device before releasing it by rotating the pin-vise counter clockwise.
Patent ductus arteriosus; Coccoon Duct Occluder; Delivery cable; Pin-vise