Congenital right pulmonary artery to left atrial fistula: Successful transcatheter closure with the cocoon duct occluder

A fistula between the right pulmonary artery (RPA) and left atrium (LA) is a rare cardiac entity. Several cases have documented surgical closure, yet only a few describe transcatheter device closure. A 14-year-old adolescent male with a history of sporting activity developed exertional dyspnea. Over a 2-year duration, the dyspnea progressed from New York Heart Association (NYHA) class II to III at the time of admission. We describe transcatheter closure of a RPA-LA fistula using a 16/18 mm Cocoon Duct Occluder (Vascular Innovations Co. Ltd., Nonthaburi, Thailand).