Former Vice President Dick Cheney is considering a heart transplant. The media say he has been receiving help from an implanted heart pump, but may exercise the option to receive a full blown transplant. Cheney has suffered five heart attacks, the first when he was age 37.
When former Vice President Dick Cheney underwent an extensive heart procedure to install a left ventricular assist device, or LVAD, last year, a system that now pumps his blood, he was extending his life. However, now it may not be a long term option supposedly.
According to a medical study of these heart pumps, 42% of patients with LVADs died within two years of having the apparatus implanted. Of the 58% that survived, 46% went without a stroke or a pump replacement over those two years.
The main hazard, however, is the formation of blood clots in the pump circuit, which can go to the brain and cause a stroke. For that reason, people with LVADs must take anticoagulant drugs.
While the devices solve the problem of life-threatening left-ventricle failure, they don’t help the right ventricle. That chamber is responsible for pumping blood to the lungs, where oxygen is picked up and carbon dioxide released. In some patients, the right ventricle is so weak it eventually fails, too.
Cheney told Chris Wallace of Fox News on television over the weekend:
“I haven’t decided yet. I’m not prepared to make any medical announcements today. I had a rough patch there for a while last year, but I have undergone major surgery last summer. I’ve been blessed with the wonders of modern medical technology. And I’m getting ready to go fishing at the end of this month and working on a book and spending a lot of time with family. So I haven’t got many complaints.”
There are currently 3,142 individuals in the United States awaiting a heart transplant, according to the United Network for Organ Sharing.
The heart transplant procedure actually consists of three full blown operations. The first operation is harvesting the heart from the donor. A team of physicians, nurses, and technicians goes to the hospital of the donor to remove donated organs once brain death of the donor has been determined. The removed organs are transported on ice to keep them alive until they can be implanted. For the heart, this is optimally less than six hours. So, the organs are often flown by airplane or helicopter to the recipient’s hospital.
The second operation is removing the recipient’s damaged heart. Removing the damaged heart may be very easy or very difficult, depending on whether the recipient has had previous heart surgery (as is often the case).
The third operation is probably the easiest, and is the actual implantation of the donor heart. Today, this operation basically involves the creation of only five lines of stitches, or “anastomoses”. These suture lines connect the large blood vessels entering and leaving the heart. Remarkably, if there are no complications, most patients who have had a heart transplant are home about one week after the surgery.
So will Cheney do it? I suppose we will all be on the edge of our seats waiting to find out.
There were 2,163 heart transplants performed in the United States in 2008 and 2,210 in 2007 and each year thousands more adults would benefit from a heart transplant if more donated hearts were available.
As of June 5, 2009, the one-year survival rate was 88% for males and 77.2% for females; the three-year survival rate was about 79.3% for males and 77.2% for females. The five-year survival rate was 73.1% for males and 67.4% for females.
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Written by Sy Kraft