Article

Possible admission to a PRM unit of a hemiplegic patient equipped
with a left ventricular assistance device (LVAD) may constitute a cause for
concern. We are reporting our observation on the subject. OBSERVATION: A
30-year-old hemiplegic patient presented with left hemiparesis secondary to a
right middle cerebral artery (MCA) ischemic stroke having occurred during
cardiopulmonary arrest. Persistence of major left ventricle dysfunction
necessitated installation on 8 November 2011 of a mono-ventricular HEART-MATE II
assistive device. Possible later recourse to cardiac transplantation would depend
on clinical development. When admitted to a PRM unit on 18 January 2012, the
patient presented with left hemiparesis and cognitive disorders. Virtually all
members of the attendant medical and paramedical team were given instruction on
the functioning of electrical power assistance systems. In spite of the
complexity of the logistics, and notwithstanding the difficulty of managing
potentially worrisome medical problems, multidisciplinary rehabilitation efforts
were successful. The patient's improved condition led to the decision to undertake heart transplantation, which was carried out on 27 October 2012.
CONCLUSION: This observation illustrates the undeniable role of
PRM in decision-making and, more generally, in the opportunities that may arise
in sensitive and challenging situations.
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Langue : ANGLAIS ; FRANCAIS