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KMID : 0352120170320010031
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Journal of Kyung Hee University
2017 Volume.32 No. 1 p.31 ~ p.36
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Anesthetic Management of a Patient with a Pulmonary Arteriovenous Malformation Undergoing Brain Abscess Removal, Open Reduction and Internal Fixation of Femur, and Laparoscopic Cholecystectomy: A Case Report
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Jeong Hyung-Mo
Kang Jong-Man
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Abstract
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Pulmonary arteriovenous malformation(PAVM) are caused by abnormal direct communications between pulmonary arteries and veins. Common clinical signs of PAVM are epistaxis, dyspnea, hypoxia, cyanosis and clubbing fingers by an intrapulmonary right to left shunt of the circulating blood without gas exchange. And neurological events like brain abscess and cerebral infarction are occurred by a paradoxical embolism across the PAVM. Thus, A comprehensive understanding of the PAVM should be considered to maintain the hypoxic pulmonary vasoconstriction response during general anesthesia and to reduce the intrapulmonary right to left shunt fraction. We report a rare case of a patient with PAVM who received three surgical procedures under general anesthesia. There were various patterns of each general anesthesia, and the patient was expired one week after the last surgery.
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KEYWORD
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Pulmonary arteriovenous malformation, Intrapulmonary shunt, General anesthesia, Hypoxic pulmonary vasoconstriction
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