Cheney may continue to rely on heart device
Former Vice President Dick Cheney, battling a lifetime of cardiac disease, has not decided whether to seek a heart transplant but could use a device surgically inserted into his chest last week as permanent therapy for his condition, according to a source close to the Cheney family and to heart surgeons familiar with the treatment.
“He has not made any decision yet about a transplant,” the source said Thursday. “He is totally focused right now on recuperation and rehab” with his current device.
The source asked not to be named while commenting on private matters.
The device implanted into the former vice president’s chest is known as an LVAD, or left ventricular assist device. It is often described as a temporary therapy representing a “bridge” to a transplant, fueling speculation that Cheney, 69, may be on the path toward seeking a new heart.
But experts said the newest models of the device, which is essentially a pump, are considered “destination therapies” that can last for years.
“There are patients who have been having a wonderful quality of life for more than five years already,” said Dr. Richard J. Shemin, chief of cardiothoracic surgery at UCLA’s Ronald Reagan Medical Center. “Because it’s a more modern device, smaller and more efficient, there is a lot of enthusiasm for it.”
Shemin has no direct knowledge of Cheney’s care.
Cheney, who suffered his first of five heart attacks at 37, announced Wednesday that he had undergone surgery to insert the device last week at Inova Fairfax Heart & Vascular Institute in Virginia. In a statement released by his office, he said the procedure addressed a new phase of “increasing congestive heart failure” but said he believed he would soon resume an active life.
Cheney may not be a good candidate for a heart transplant, primarily because of his age. The scarcity of available hearts means that surgeons typically prefer to reserve them for younger patients with longer expected life spans.
Other factors that could rule out a transplant include an uncontrollable cancer and a chronic infection that would be exacerbated by the immunosuppression required with the device, said Dr. Paul Mazur, a cardiothoracic surgeon at MemorialCare Heart & Vascular Institute in Fountain Valley, Calif.
“This device has been a saving grace for a lot of patients with advanced heart failure,” Mazur said. “It will get them out and walking about again.”
LVADs, which are much different from artificial hearts, were originally bulky devices designed to take some of the pumping load off of a weakened heart until a transplant could be arranged. Newer devices are smaller and often have no more than one moving part, minimizing the possibility of clotting. Everything is implanted in the chest except for the batteries, which are worn on a vest much like a hunting vest.
One potential oddity is that most patients who have the device have neither a pulse nor a conventional blood pressure, and must carry medical documentation saying that the lack of a pulse does not mean they are dead.
“The patient is going to look like a walking zombie,” Mazur said.
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