{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T15:20:53Z","timestamp":1780500053016,"version":"3.54.1"},"reference-count":15,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,2,24]]},"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:p>Penetrating cardiac injuries usually require emergent surgical intervention. Our patient presented to the trauma centre with multiple stab wounds to the neck, chest, epigastric region and abdomen. She arrived haemodynamically stable, and her initial Focused Assessment with Sonography for Trauma exam was negative. Her chest X-ray did not show any evident pneumothorax or haemothorax. Due to her injury pattern, she was taken to the operating room for exploratory laparotomy and neck exploration. Postoperatively, she was taken for CT and found to have a contained cardiac rupture. The injury was contained within previous scar tissue from her prior cardiac surgery. Further evaluation revealed that the injury included a penetrating stab wound to the right ventricle and a traumatic ventricular septal defect (VSD). She subsequently underwent a redo sternotomy with the repair of the penetrating stab wound and the VSD. Cardiology, intensive care, trauma surgery and cardiothoracic surgery coordinated her care from diagnosis, management and recovery. This case highlights the challenges in the management of cardiac injuries and the benefits of a multidisciplinary approach to care for complex cardiac injuries.<\/jats:p>","DOI":"10.1136\/bcr-2023-257855","type":"journal-article","created":{"date-parts":[[2024,3,5]],"date-time":"2024-03-05T12:06:13Z","timestamp":1709640373000},"page":"e257855","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Management of contained penetrating cardiac injury in a patient with prior cardiac surgery"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0772-236X","authenticated-orcid":false,"given":"Toyokazu","family":"Endo","sequence":"first","affiliation":[{"name":"Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3321-983X","authenticated-orcid":false,"given":"Matthew G","family":"Peters","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C Danielle","family":"Hopkins","sequence":"additional","affiliation":[{"name":"University of Louisville School of Medicine, Louisville, Kentucky, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark S","family":"Slaughter","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Thoracic Surgery, University of Louisville School of Medicine, Louisville, Kentucky, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith R","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,3,5]]},"reference":[{"key":"2025082804031225000_17.3.e257855.1","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1007\/s00068-017-0806-6","article-title":"Penetrating cardiac injuries: predictive model for outcomes based on 2016 patients from the National trauma data bank","volume":"44","author":"Asensio","year":"2018","journal-title":"Eur J Trauma Emerg Surg"},{"key":"2025082804031225000_17.3.e257855.2","doi-asserted-by":"crossref","DOI":"10.25100\/cm.v52i2.4519","article-title":"Damage control in penetrating cardiac trauma","volume":"52","author":"Gonz\u00e1lez-Hadad","year":"2021","journal-title":"Colomb Med (Cali)"},{"key":"2025082804031225000_17.3.e257855.3","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1016\/j.athoracsur.2019.12.038","article-title":"Ten-year trends in traumatic cardiac injury and outcomes: A trauma Registry analysis","volume":"110","author":"Tran","year":"2020","journal-title":"Ann Thorac Surg"},{"key":"2025082804031225000_17.3.e257855.4","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.sopen.2022.11.001","article-title":"Penetrating cardiac trauma","volume":"11","author":"Lee","year":"2023","journal-title":"Surg Open Sci"},{"key":"2025082804031225000_17.3.e257855.5","doi-asserted-by":"publisher","DOI":"10.1177\/021849230401200212"},{"key":"2025082804031225000_17.3.e257855.6","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1177\/000313489906500611","article-title":"Combined blunt cardiac and Pericardial rupture: review of the literature and report of a new diagnostic algorithm","volume":"65","author":"May","year":"1999","journal-title":"The American Surgeon"},{"key":"2025082804031225000_17.3.e257855.7","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3181b16f30"},{"key":"2025082804031225000_17.3.e257855.8","doi-asserted-by":"crossref","DOI":"10.1016\/j.tcr.2020.100327","article-title":"False negative of Pericardial effusion using focused assessment with Sonography for trauma and enhanced CT following traumatic cardiac rupture; 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