After five heart attacks, former Vice President Dick Cheney’s ticker has taken a beating. Last week, he said that he underwent surgery to install a new heart pump.
What he got was a LVAD, or left ventricular assist device, which is made for people like Cheney who need a little help pumping blood because their hearts aren’t keeping up.
The pump runs something like a drill bit, continuously rotating at 9,000 rotations per minute rather than squeezing and releasing, so Cheney now officially has no pulse, according to Dr. Stuart D. Russell, chief of heart failure and transplantation at Johns Hopkins’ Comprehensive Transplant Center.
But what he’s likely getting in return, says Russell, who is not involved in Cheney’s care, is a better quality and quantity of life.
Cheney said in a statement that he had “increasing congestive heart failure,” which afflicts about 5 million Americans whose hearts have weakened over time. In most candidates for the device, the amount of have blood squeezed out with each beat is significantly reduced – normal is 55 percent or greater and Cheney was likely more in the 10-15 percent range. That makes the people grow tired quickly after doing minor chores such as dressing.
Pumps have been around for about three decades, but this version by Thoratech Corp., at about five years old, gives people a 60 percent survival rates after 2 years. There’s not a lot of data on this pump after that. Drug therapy, in contrast, gives patients about a 10 percent survival rate.
“That’s a lot better than 10 percent on the pills,” Russell said. “Some would say going from 10 percent to 60 percent is phenomenal.”
Some patients use the device, Russell said, as a bridge to a transplant. But Cheney, at 69, might not be a candidate. In that case it’s a “destination therapy,” meaning this is his treatment destination.
But Russell says that he could live 4,5 or 6 years with this pump and new ones already are in development. And “6 years for a 69-year-old who has had 5 heart attacks is significant,” he said.
Russell said those who get this pump are generally in the hospital 14 to 21 days and start to feel normal after two to three months. The device requires an energy source, so the people have a line coming out of their skin near their belly that need to be hooked up to a battery pack during the day -- it can be worn holster-style if Cheney prefers. It also needs to be plugged into an energy source at night.
It can’t get submerged, so wearers can’t swim but they can shower. They also need to take anti-coagulation drugs. They are also at increased risk of infection and gastrointestinal tract infections.
“People generally can get back to a fairly normal lifestyle,” Russell said. “The vast majority do well.”
Graphic reprinted permission from Thoratec Corp.