Dick Cheney may not have a pulse, but part of his ticker is spinning at 9,000 RPM. The former Vice President provided an instant laugh line for comedians this week when it was revealed that during his latest heart surgery, doctors installed a new implant called left ventricular assist device, or LVAD.
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 [Baltimore Sun].
A device like Cheney's is implanted in his chest, with the exception of the batteries, which the user must wear in a separate vest. (Though the Baltimore Sun
reports that patients can wear the power source "holster style," which may be more Cheney's style.) So what does this thing do? As the LVAD's name would suggest, it's not a replacement heart itself—the device offers the heart an assist. Specifically, if the heart is struggling to pump blood from the left ventricle
to the aorta—the body's largest artery, which disperses blood throughout the body—the LVAD can offer a mechanical bypass. Surgeons attach a pump to the left ventricle of the heart, and blood
flows from there into the pump. The pump's rotating action helps to push the blood back up into the aorta. Patients have to supplement the device by taking anticoagulant medications that prevent blood clots.
Most such pulse-less patients feel nothing unusual. But they are urged to wear bracelets or other identifications to alert emergency room doctors as to why they have no pulse [The New York Times].
Having the LVAD in place should make it possible for Cheney, whose congestive heart failure is worsening, to lead an active life. No swimming, though: The device can't be submerged. For Cheney, whose beleaguered heart suffered the first of five attacks at the age of 37 and endured a quadruple bypass in 1988, the question now is whether his LVAD is a stepping stone to something else. The LVAD was originally intended that way, as a stop-gap for a patient awaiting a heart transfer.
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 [Baltimore Sun].
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Image: White House/David Bohrer
