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KMID : 0356920080540060673
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Korean Journal of Anesthesiology
2008 Volume.54 No. 6 p.673 ~ p.676
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Atrial Fibrillation during Ethanol Sclerotherapy in a Patient with Lower Limb Arteriovenous Malformation - A case report -
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Chung In-Sun
Choi Soo-Joo
Lee Sang-Min
Gwak Mi-Sook
Yoon Jin-Sun
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Abstract
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Alcohol embolization or sclerotherapy has been commonly used for a treatment of arteriovenous malformation (AVM). Alcohol sclerotherapy frequently produces minor local complications but may rarely produce catastrophic cardiopulmonary complications. In this case, general anesthesia was induced and the pulmonary artery pressure was monitored. After absolute alcohol (99.6% ethanol) injection, the systolic pulmonary artery pressure was increased, the systemic blood pressure was decreased and the EKG rhythm revealed supraventricular tachycardia and atrial fibrillation. Nitroglycerine, dobutamine, and milrinone infusions were started for the treatment of pulmonary hypertension. The EKG was restored to normal sinus rhythm two hours after judicious fluid administration and other vital signs were also recovered. The anesthesiologists must be aware of potentially serious cardiopulmonary complications possible with alcohol sclerotherapy and be prepared to manage severe cardiovascular compromise.
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KEYWORD
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arteriovenous malformation, atrial fibrillation, ethanol sclerotherapy, pulmonary hypertension
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