{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T05:07:08Z","timestamp":1780463228893,"version":"3.54.1"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Penetrating thoracic trauma accounts for only 1%\u201313% of chest injury hospitalizations but is associated with high mortality due to involvement of the heart, great vessels, and lungs. Among these, foreign body injuries with retained objects are rare, and the role of specific structural features such as barbs in limiting injury severity has not been well described.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 54-year-old male sustained a penetrating injury to the right anterior chest from a barbed shark dart while fishing. On admission, he was relatively stable but with compensated hemodynamics. Echocardiography showed pericardial effusion with signs of early tamponade. Chest CT confirmed that the cylindrical foreign body had traversed the chest wall, the middle lobe of the right lung, and the pericardium, with the tip abutting the right atrial wall. Emergency median sternotomy revealed that the barbed shark dart had penetrated the right lung and pericardium and reached the right atrium. Notably, the backward-facing barbs at the posterior end of the dart prevented further forward migration, thereby averting perforation of the posterior right atrial wall and catastrophic bleeding. The foreign body was removed, the atrial puncture site was repaired, and a wedge resection of the injured lung was performed. The patient recovered uneventfully and remained asymptomatic at 1-year follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case highlights a unique \u201cself-limiting\u201d mechanism of penetrating cardiac injury, in which the barbed structure of the foreign body paradoxically reduced the extent of cardiac damage. Injury patterns in penetrating thoracic trauma depend heavily on the kinetic energy and structural characteristics of the object. For stable patients, a multidisciplinary approach involving imaging-guided surgical planning is critical.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1859460","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T04:55:45Z","timestamp":1780462545000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Self-limiting penetrating cardiothoracic injury from a barbed shark dart involving the right atrium"],"prefix":"10.3389","volume":"13","author":[{"given":"Xiong","family":"Tan","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, Affiliated Hospital of North Sichuan Medical College","place":["Nanchong, Sichuan Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weikai","family":"Dong","sequence":"additional","affiliation":[{"name":"Cardiovascular Medical Center, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School","place":["Nanjing, Jiangsu Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Affiliated Hospital of North Sichuan Medical College","place":["Nanchong, Sichuan Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinglong","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Affiliated Hospital of North Sichuan Medical College","place":["Nanchong, Sichuan Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinjie","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Surgery Center, Affiliated Hospital of North Sichuan Medical College","place":["Nanchong, Sichuan Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e12376","DOI":"10.1097\/MD.0000000000012376","article-title":"A case report of a polytrauma patient with penetrating iron rods in thorax and head","volume":"97","author":"Tang","year":"2018","journal-title":"Medicine (Baltimore)"},{"key":"B2","doi-asserted-by":"publisher","first-page":"110971","DOI":"10.1016\/j.injury.2023.110971","article-title":"Outcomes and potential for improvement in the prehospital treatment of penetrating chest injuries in a European metropolitan area: a retrospective analysis of 2009\u20132017","volume":"55","author":"Krammel","year":"2024","journal-title":"Injury"},{"key":"B3","doi-asserted-by":"publisher","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":"B4","doi-asserted-by":"publisher","first-page":"e20240049","DOI":"10.21470\/1678-9741-2024-0049","article-title":"Penetrating cardiac injury: a 20-year retrospective analysis at a high-complexity university center","volume":"40","author":"Wada","year":"2025","journal-title":"Braz J Cardiovasc Surg"},{"key":"B5","doi-asserted-by":"publisher","first-page":"111214","DOI":"10.1016\/j.ijscr.2025.111214","article-title":"Penetrating cardiac injury with non-coronary cusp aortic valve rupture and ventricular septal injury: a case report","volume":"129","author":"Wadaja","year":"2025","journal-title":"Int J Surg Case Rep"},{"key":"B6","doi-asserted-by":"publisher","first-page":"e81","DOI":"10.1093\/milmed\/usx034","article-title":"Imaging of combat-related thoracic trauma - 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