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폐동정맥기형(Pulmonary Arteriovenous Malformation) 환자의 뇌농양제거술, 대퇴골 개방정복 및 내고정술, 복강경하 담낭절제술 시 마취관리 경험
정형모 ( Hyungmo Jeong ),강종만 ( Jong-man Kang ) 경희대학교 경희의료원 2017 慶熙醫學 Vol.32 No.1
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.