Transrectal EUS-guided FNA biopsy of a presacral chordoma-report of a case and review of the literature

Abstract

AIM:To evaluate the value of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) level for predicting postoperative atrial fibrillation (AF) in patients undergoing surgery for esophageal carcinoma. METHODS:NT-proBNP levels were measured in 142 patients 24 h before and 1 h after surgery for esophageal carcinoma. All patients having a preoperative cardiac diagnosis by electrocardiogram (ECG), remained under continuous monitoring for at least 48 h after surgery, and then underwent clinical cardiac evaluation until discharge.RESULTS: Postoperative AF occurred in 11 patients (7.7%). AF patients were significantly older (69.6 ± 12.2 years vs 63.4 ± 13.3 years, P = 0.031) than non-AF patients. There were no significant differences in history of diabetes mellitus, sex distribution, surgical approach, anastomosis site, intraoperative hypotension and postoperative fever. The preoperative plasma NT-proBNP level was significantly higher in patients who developed postoperative AF (121.3 ± 18.3 pg/mL vs 396.1 ± 42.6 pg/mL, P = 0.016). After adjustment for age, gender, chronic obstructive pulmonary disease (COPD), history of cardiac diseases, hypertension, postoperative hypoxia and thoracic-gastric dilation, NT-proBNP levels were found to be associated with the highest risk factor for postoperative AF (odds ratio = 4.711, 95% CI = 1.212 to 7.644, P = 0.008).CONCLUSION: An elevated perioperative plasma BNP level is a strong and independent predictor of postoperative AF in patients undergoing surgery for esophageal carcinoma. This finding has important implications for identifying patients at higher risk of postoperative AF who should be considered for preventive antiarrhythmic therapy.

Correlation between N-Terminal Pro-Brain Natriuretic Peptide and Doppler Echocardiographic Parameters of Left Ventricular Filling Pressure in Atrial Fibrillation

“… 8) Elevated levels of NT-proBNP have been found to predict occurrence of new AF in subjects obtained from the general population, 9) and postoperative AF in patients undergoing surgery. 10) 11) In this study, we found NT-proBNP levels to be significantly elevated in patients with AF compared to the patients with sinus rhythm. Atrial enlargement and LV diastolic dysfunction were noted in patients with AF.…”

“…NT-proBNP has been known to be elevated in cardiac dysfunction and is widely used for both the diagnosis and evaluation of heart failure 8). Elevated levels of NT-proBNP have been found to predict occurrence of new AF in subjects obtained from the general population,9) and postoperative AF in patients undergoing surgery 10)11). In this study, we found NT-proBNP levels to be significantly elevated in patients with AF compared to the patients with sinus rhythm.…”

Natriuretic Peptides for the Detection of Paroxysmal Atrial Fibrillation in Patients with Cerebral Ischemia – the Find-AF Study

“…Natriuretic peptides have been shown to be predictive for future AF in a number of different clinical settings [8] , [14] , including the general population [7] , [15] . However, no previous study has evaluated its usefulness for the detection of paroxysmal AF.…”

Unusual Presentation of the Retrorectal Neoplasm Masquerading as a Subcutaneous Hip Tumor

“…A recent report indicated the usefulness of transrectal endoscopic ultrasonography-guided fine needle aspiration biopsy of a presacral chordoma, although this approach had been previously thought to be a contraindication. 2 Because surgical resection confirms the definite diagnosis, this eliminates the need for biopsy. The posterior (transsacral), anterior (abdominal), and combined pelvic approaches enable good accesses for complete en bloc resection of tumor with adjacent involved structures.…”