Kardiochirurgia I Torakochirurgia Polska最新文献

{"title":"Del Nido versus Bretschneider HTK cardioplegia in adult aortic valve replacement: early clinical outcomes from a randomised trial.","authors":"Barbara Brzeska, Wojciech Karolak, Paweł Żelechowski, Andrzej Łoś, Nikodem Ulatowski, Rafał Pawlaczyk","doi":"10.5114/kitp.2026.160645","DOIUrl":"https://doi.org/10.5114/kitp.2026.160645","url":null,"abstract":"<p><strong>Introduction: </strong>The search for the perfect cardioplegic solution continues. Although del Nido cardioplegia has achieved undeniable success in paediatric cardiac surgery, it has not gained comparable popularity in adult cases.</p><p><strong>Aim: </strong>This prospective randomised trial aimed to compare the cardioprotective properties and in-hospital clinical outcomes of two single-dose cardioplegic solutions: del Nido and Bretschneider HTK.</p><p><strong>Material and methods: </strong>One hundred adult patients scheduled for elective aortic valve replacement were randomly assigned to receive either del Nido or Bretschneider HTK cardioplegia. Details regarding cardiopulmonary bypass, the intra- and postoperative periods, and cardiac enzyme levels were collected.</p><p><strong>Results: </strong>Cardiac enzyme concentrations were similar between the two groups across all postoperative measurements. Only a correlation between cardiac markers and reperfusion time in the del Nido group was found. The Bretschneider HTK group showed a greater need for defibrillation after cross-clamp removal and lower pH values during cardiopulmonary bypass. No other significant differences in postoperative complications or laboratory results were observed.</p><p><strong>Conclusions: </strong>Del Nido and Bretschneider HTK cardioplegic solutions provide comparable cardioprotection and in-hospital clinical outcomes when used during elective aortic valve replacement. However, the use of Bretschneider HTK significantly increases the need for defibrillation and leads to greater intraoperative metabolic acidosis. Despite these findings, the cardiac enzyme levels in the postoperative period remain unaffected.</p>","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"23 1","pages":"31-38"},"PeriodicalIF":1.3,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparative study of axillary and innominate artery cannulation: insights from clinical experience in acute type A aortic dissection.","authors":"Görkem Yiğit, Ayla Ece Çelikten, Ufuk Türkmen, Kudret Atakan Tekin, Sertan Özyalçın, Adem İlkay Diken","doi":"10.5114/kitp.2026.160657","DOIUrl":"https://doi.org/10.5114/kitp.2026.160657","url":null,"abstract":"<p><strong>Introduction: </strong>Stanford acute type A aortic dissection (ATAAD) repair requires complex circulatory and cerebral protection. Although various neuroprotective techniques have been proposed, the optimal strategy remains controversial.</p><p><strong>Aim: </strong>This study compared innominate artery (IA) and right axillary artery (AXA) cannulation in ATAAD repair based on early- and mid-term outcomes.</p><p><strong>Material and methods: </strong>Forty-six patients who underwent emergency ATAAD repair between January 2021 and April 2024 were retrospectively analyzed. Group 1 included patients with AXA cannulation (<i>n</i> = 18), and group 2 consisted of IA cannulation cases (<i>n</i> = 28). Primary endpoints were operative mortality (all-cause mortality at 30 days), postoperative neurological events, and major adverse cardiac and cerebrovascular events (MACCEs). Secondary endpoints included re-exploration, stroke, upper limb ischemia, and wound infections.</p><p><strong>Results: </strong>No statistically significant differences were found between the groups regarding early mortality and cerebral events. Thirty-day mortality was 33.3% (<i>n</i> = 6) in the AXA group and 21.4% (<i>n</i> = 6) in the IA group (<i>p</i> = 0.493). Stroke or TIA occurred in 11.1% (<i>n</i> = 2) of AXA patients and 7.1% (<i>n</i> = 2) of IA patients (<i>p</i> = 0.549). Intensive care unit and hospital stays, end-organ complications, and re-exploration rates were similar. Kaplan-Meier survival analysis showed comparable 1-year survival (66.7% vs. 82.8%, <i>p</i> = 0.558). Logistic regression identified coronary artery disease (OR = 4.364), aortic diameter (OR = 1.219), lowest body temperature (OR = 0.788), and AXA cannulation (OR = 0.115) as independent predictors of mortality.</p><p><strong>Conclusions: </strong>Both IA and AXA cannulation are effective for ATAAD repair. However, IA cannulation reduced cannulation-related complications, offering a safe alternative for antegrade cerebral perfusion with comparable early mortality and complication rates.</p>","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"23 1","pages":"48-55"},"PeriodicalIF":1.3,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medium-term results and the impact of structural valve deterioration of Trifecta versus Perceval bioprostheses: analysis from the Perfecta study.","authors":"Paolo Nardi, Claudia Altieri, Alessandro Cristian Salvati, Dario Buioni, Federico Agneni, Mattia Scognamiglio, Carlo Bassano, Valentina Ajello, Giovanni Ruvolo, Augusto D'Onofrio","doi":"10.5114/kitp.2026.160638","DOIUrl":"https://doi.org/10.5114/kitp.2026.160638","url":null,"abstract":"<p><strong>Introduction: </strong>Surgical aortic valve replacement remains the most effective treatment for severe aortic valve disease, thanks to the evolution and development of new-generation biological prostheses.</p><p><strong>Aim: </strong>The study aimed to compare the follow-up results of aortic valve replacement with implantation of the Perceval sutureless bioprosthesis and St. Jude Trifecta sutured bioprosthesis (the single-center Perfecta study), evaluating the following end-points: survival, event-free survival rates, and impact of structural valve deterioration (SVD) on freedom from reintervention.</p><p><strong>Material and methods: </strong>Between December 2014 and June 2023, 280 patients underwent aortic valve replacement with Trifecta (<i>n</i> = 220; mean age: 75.2 ±6.5 years) and Perceval implantation (<i>n</i> = 60; mean age: 77.9 ±5.1 years); 274 survivors (Trifecta = 214, Perceval = 60) were followed.</p><p><strong>Results: </strong>At 7 years for both bioprostheses, Trifecta vs.Perceval, survival (68 ±4.1% vs. 89 ±4.8%; <i>p</i> = 0.19), freedom from cardiac death (90 ±2.3% vs. 94 ±1.7%; <i>p</i> = 0.38), from endocarditis (96 ±1.4% vs. 94 ±3.0%; <i>p</i> = 0.99) and from reintervention (98 ±1.4% vs. 100%; <i>p</i> = 0.13) were similar. SVD was observed in 60 Trifecta implants - 53 of which were in the initial stages - and in one in Perceval implant. Freedom from overall SVD was 74 ±4.2% vs. 93 ±6.4% (<i>p</i> = 0.09). Moderate patient-prosthesis mismatch was more frequently observed in the Trifecta than the Perceval group (<i>n</i> = 38 [17.3%] vs. <i>n</i> = 5 [8.2%]; <i>p</i> = 0.004). Independent predictors of SVD, both in the initial stages and overall, were Trifecta implantation (HRs 20.5;22.4) and moderate PPM (HRs 2.5;2.3). NYHA class (I-II 79.6% and 98.3% vs. 46.3% and 40%) significantly improved compared to preoperatively in both groups (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Both bioprostheses appear to confer equally satisfactory late outcomes. Although the Trifecta prosthesis carries a higher risk of SVD, this risk does not seem to be significantly associated with worse clinical conditions or need for reoperation. The Perceval prosthesis can be considered a viable option in the context of the latest-generation bioprostheses.</p>","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"23 1","pages":"39-47"},"PeriodicalIF":1.3,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"False-negative results of combined endobronchial and endoscopic ultrasound in mediastinal staging of lung cancer.","authors":"Karolina Gambuś, Konrad Moszczyński, Sofiia Popovchenko, Artur Szlubowski, Adam Ćmiel, Piotr Kocoń, Błażej Kużdżał","doi":"10.5114/kitp.2026.160677","DOIUrl":"https://doi.org/10.5114/kitp.2026.160677","url":null,"abstract":"<p><strong>Introduction: </strong>Accurate assessment of mediastinal lymph node involvement is crucial for treatment planning in lung cancer. Combined endobronchial and endoscopic ultrasound (CUS) offers high sensitivity and negative predictive value (NPV), but false negative (FN) results remain a concern due to their potential impact on treatment strategies.</p><p><strong>Aim: </strong>We aimed to analyze factors associated with FN CUS results in patients with lung cancer.</p><p><strong>Material and methods: </strong>We conducted a retrospective analysis of a prospective database of adult patients with lung cancer clinical stage I-IVA, staged using positron emission tomography (PET), computed tomography (CT), and CUS, who underwent lung resection. The analyzed data included age, sex, body mass index (BMI), tumor histology and grade, lobar location, stage of the disease and maximum standardized uptake values (SUV_max) of the primary tumor and lymph nodes.</p><p><strong>Results: </strong>Among 775 analyzed patients, there were 86 (11%) FN results. The risk of FN CUS results was significantly associated with female sex (<i>p</i> = 0.014), adenocarcinoma histology (<i>p</i> = 0.039), higher clinical stage determined using both CT (<i>p</i> = 0.001-0.036) and PET (<i>p</i> = 0.001-0.028), higher SUV of N2 nodes (<i>p</i> < 0.001), and higher SUV of N1 nodes (<i>p</i> = 0.012). No significant association was found between the risk of FN CUS results and patients' age (<i>p</i> = 0.421), BMI (<i>p</i> = 0.921), or primary tumor characteristics, including lobar location (<i>p</i> = 0.29-0.99), grade (<i>p</i> = 0.67-0.88), and SUV_max (<i>p</i> = 0.12).</p><p><strong>Conclusions: </strong>FN CUS results are more likely in women, with adenocarcinoma histology and higher clinical stage determined using CT and PET. Age, BMI, and primary tumor lobar location, grade, and SUVmax are not predictors of FN.</p>","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"23 1","pages":"8-13"},"PeriodicalIF":1.3,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stereotactic ablative radiotherapy versus surgery in octogenarian patients with early-stage lung cancer: a retrospective cohort study.","authors":"Ghaith Qsous, Aditya Roshan, Naveed Kuniyil, Vipin Zamvar, Renzo Pessotto, Malcolm Will","doi":"10.5114/ms.2026.160604","DOIUrl":"https://doi.org/10.5114/ms.2026.160604","url":null,"abstract":"<p><strong>Introduction: </strong>With the adoption of lung cancer screening worldwide, there will be more patients presenting with early-stage lung cancer. Many of these patients are elderly (≥ 80 years old).</p><p><strong>Aim: </strong>We aimed to determine the best treatment option for this group of patients.</p><p><strong>Material and methods: </strong>Between 2013 and 2023, 160 patients aged ≥ 80 years with early-stage lung cancer (T1-2, N0) underwent either surgical resection (78 patients) or stereotactic ablative radiotherapy (SABR) (82 patients). Propensity-score matching with replacement was applied, in conjunction with analysis of the unmatched cohort, to assess differences related to age, performance status (PS), forced expiratory volume in the first second (FEV₁), and Charlson Comorbidity Index (CCI).</p><p><strong>Results: </strong>There was a significant difference in overall survival and 5-year survival of patients who underwent surgery compared to SABR (29% vs. 19.9%; <i>p</i> < 0.001; 52.5% vs. 23.1%; <i>p</i> = 0.001). The SABR group had a lower rate of recurrence compared to the surgery group, but this difference was not significant (12.2% vs. 15.3%; <i>p</i> = 0.558). The propensity score-matched cohort yielded 73 pairs, and suggested better survival at 5 years for patients who underwent surgery compared to SABR (54.5% vs. 18.5%; <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Surgery may provide a survival benefit when compared to SABR therapy for elderly patients in the longer term. SABR remains an important consideration for those who may not tolerate surgery, especially in the short term.</p>","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"23 1","pages":"1-7"},"PeriodicalIF":1.3,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of early outcomes of coronary artery bypass grafting between junior and senior surgeons.","authors":"Osman F Beyazal, Zeki Zemizturk, Cemalettin Aydin, Abdullah B Balci, Gizem Kolay, Abdussamet Asaroglu, Nihan Kayalar, Mehmed Yanartas","doi":"10.5114/kitp.2026.160588","DOIUrl":"https://doi.org/10.5114/kitp.2026.160588","url":null,"abstract":"<p><strong>Introduction and aim: </strong>The aim of this study was to compare the postoperative results in detail in patients who underwent isolated coronary artery bypass grafting (CABG) without patient selection between junior and senior surgeons and to investigate the adequacy of the 5-year residency training provided in Turkey.</p><p><strong>Material and methods: </strong>Between 2024 and 2025, 514 patients (424 males; mean age: 60 ±9.0 years) who underwent isolated CABG were evaluated. The patients were divided into two groups: Group A (<i>n</i> = 240) treated by junior surgeons and Group B (<i>n</i> = 274) treated by senior surgeons.</p><p><strong>Results: </strong>There was no significant difference between the groups regarding basic demographic characteristics, EuroSCORE II, or comorbid diseases. Cross-clamp (XCL) time and cardiopulmonary bypass (CPB) time were higher in the junior surgeon group than in the senior surgeon group (median XCL time: 88 vs. 74 min; median CPB time: 140 vs. 121 min, respectively). There were no differences between junior and senior surgeons in any postoperative outcomes, including postoperative exploration, cerebrovascular accident, need for continuous renal replacement therapy, postoperative atrial fibrillation, superficial sternal wound infection, deep sternal wound infection, gastrointestinal bleeding, need for percutaneous coronary intervention, pleural effusion, need for intra-aortic balloon pump, extracorporeal membrane oxygenation need, tracheostomy, intubation time, intensive care unit stay, hospital stay, total mortality, early mortality, and late mortality.</p><p><strong>Conclusions: </strong>In isolated, less complex CABG patients, junior surgeons achieved postoperative early outcomes comparable to those of senior surgeons. Although junior surgeons had longer XCL and CPB times, we did not find any significant differences in clinical outcomes.</p>","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"23 1","pages":"14-23"},"PeriodicalIF":1.3,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of indocyanine green in thoracic surgery: a literature review.","authors":"Krzysztof Walczak, Marta Ślefarska-Wasilewska, Robert Smolec, Mateusz Rydel, Łukasz Braszczok, Damian Czyżewski","doi":"10.5114/kitp.2026.160570","DOIUrl":"https://doi.org/10.5114/kitp.2026.160570","url":null,"abstract":"<p><p>Indocyanine green (ICG) is a fluorescent dye used for near-infrared (NIR) intraoperative imaging. In thoracic surgery, it is used to delineate intersegmental planes during anatomical segmentectomy, localizing small, nonpalpable lung lesions, assessing gastric conduit perfusion before esophageal anastomosis, and identifying the thoracic duct. A review of the latest literature (2020-2025) indicates that ICG significantly increases the precision of segmentectomy (allowing visualization of the intersegmental plane) and the effectiveness of lung nodule localization (> 95%), as well as enabling objective assessment of tissue perfusion in esophageal surgery (reduction of anastomotic leakage) and facilitating identification and management of thoracic duct injuries. The fluorescence technique with ICG has a favourable safety profile. Indocyanine green is currently a valuable complement to standard methods, increasing the predictability and effectiveness of minimally invasive procedures in the thoracic region.</p>","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"23 1","pages":"64-70"},"PeriodicalIF":1.3,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous pneumothorax in fibrotic silicosis: lessons from surgical management.","authors":"Vasileios Leivaditis, Sofoklis Mitsos, Konstantinos Grapatsas, Francesk Mulita, Athanasios Papatriantafyllou, Konstantinos Tasios, Elias Liolis, Andreas Antzoulas, Dimitrios Litsas, Panagiotis Dimitrios Papadopoulos, George Theofanis, Konstantinos Nikolakopoulos, Ioannis Panagiotopoulos, Periklis Tomos, Dimitrios Schizas, Manfred Dahm","doi":"10.5114/kitp.2026.160550","DOIUrl":"https://doi.org/10.5114/kitp.2026.160550","url":null,"abstract":"","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"23 1","pages":"76-80"},"PeriodicalIF":1.3,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uniportal video-assisted thoracoscopic surgery apicoposterior segmentectomy with radical lymphadenectomy: a high-complexity case with educational value.","authors":"Łukasz Marciniak, Janusz Kowalewski","doi":"10.5114/kitp.2026.160569","DOIUrl":"https://doi.org/10.5114/kitp.2026.160569","url":null,"abstract":"","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"23 1","pages":"74-75"},"PeriodicalIF":1.3,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Operative management of unstable sternal fracture in polytrauma: a case report and literature review.","authors":"Chrysa Andrikopoulou, Edvin Selmani, Vasileios Leivaditis, Panagiotis Antzoulas, Konstantinos Tasios, Elias Liolis, Andreas Antzoulas, Dimitrios Litsas, Panagiotis Dimitrios Papadopoulos, George Theofanis, Konstantinos Nikolakopoulos, Ioannis Panagiotopoulos, Dimitrios Schizas, Antonios Kouzelis, Efstratios Koletsis, Sofoklis Mitsos, Periklis Tomos, Agron Dogjani, Francesk Mulita","doi":"10.5114/kitp.2026.160556","DOIUrl":"https://doi.org/10.5114/kitp.2026.160556","url":null,"abstract":"<p><p>Sternal fractures are uncommon but clinically relevant injuries, most often resulting from blunt thoracic trauma in motor vehicle collisions. While most isolated fractures can be treated conservatively, surgical stabilisation may be required in cases of displacement, instability, or polytrauma. Modern plating techniques offer biomechanical advantages over traditional wire fixation, but indications remain variably defined. We report the case of a 33-year-old male polytrauma patient involved in a high-impact motor vehicle accident. He sustained a displaced sternal fracture with manubriosternal dislocation, bilateral rib fractures (right 4^th-8^th, left 6^th-7^th), flail chest, pulmonary contusion, a retrosternal haematoma, and left hip dislocation. Surgical management included open reduction and internal fixation of the sternum with 2 titanium plates, haematoma evacuation, and orthopaedic intervention. The postoperative course was initially uneventful; however, the patient was readmitted 1 month later with a surgical site infection caused by <i>Proteus mirabilis</i>.</p>","PeriodicalId":49945,"journal":{"name":"Kardiochirurgia I Torakochirurgia Polska","volume":"23 1","pages":"56-63"},"PeriodicalIF":1.3,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}