Dick Cheney’s Heart Gets Assistance

Former Vice President Dick Cheney is recovering from major heart surgery. The VP, who is no stranger to heart problems, has had five heart attacks, the first at age 37.  He has undergone four-vessel coronary artery bypass grafting in 1988, coronary artery stenting in November 2000, urgent coronary balloon angioplasty in March 2001, and the implantation of an implantable cardioverter-defibrillator in June, 2001. This week, in response to increasing congestive heart failure,  he received a ventricular assist device to help his heart pump better.

What Is a Ventricular Assist Device? (Source- NHLBI)

A ventricular assist device (VAD) is a mechanical pump that’s used to support heart function and blood flow in people who have weakened hearts. The device takes blood from a lower chamber of the heart and helps pump it to the body and vital organs, just as a healthy heart would. A VAD may be used if one or both of the heart’s lower chambers, the ventricles don’t work properly.

Overview

A VAD may be of benefit in patients whose ventricles don’t work well due to heart disease. A VAD can help support the heart:

  • During or after surgery, while the heart recovers.
  • In eligible patients waiting for a heart transplant.
  • For those ineligible for a heart transplant, a VAD can be a long-term solution to help the heart work better.

The basic parts of a VAD include: a small tube that carries blood out of the heart into a pump; another tube that carries blood from the pump to the blood vessels which deliver the blood to your body; and a power source. The power source is connected to a control unit that monitors the VAD’s functions. The control unit gives warnings, or alarms, if the power is low or if it senses that the device isn’t working right. Some VADs pump blood like the heart does, with a pumping action. Other VADs keep up a continuous flow of blood.

Types of Ventricular Assist Devices

The two basic types of VADs are a left ventricular assist device (LVAD) and a right ventricular assist device (RVAD). The LVAD is the most common type of VAD. It helps the left ventricle pump blood to the aorta. The aorta is the main artery that carries oxygen-rich blood from your heart to your body.

VADs have two basic designs. A transcutaneous VAD has its pump and power source located outside of the body. Tubes connect the pump to the heart through small holes in the abdomen. This type of VAD may be used for short-term support during or after surgery.

An implantable VAD has its pump located inside of the body and its power source located outside of the body. A cable connects the pump to the power source through a small hole in the abdomen.

Implantable VADs mainly are used in those patients waiting for a heart transplant or as a long-term solution in patients who are not a transplant candidates.

Outlook

Until recently, VADs were too big to fit in many people’s chests, especially women. Only people who had large chests could get one.

Now implantable VADs can fit in most adults and even some older children. Devices small enough for young children aren’t yet available, but they’re being developed.

Researchers have made advances in how well VADs work and how much they improve people’s quality of life. In the past, VADs mostly were used for people who had end-stage heart failure. Now VADs also can help people who have earlier stages of heart failure.

For more information, click here to see Resounding Health’s casebook on Ventricular Assist Devices.

Mark Boguski, M.D., Ph.D. is on the faculty of Harvard Medical School and is a member of the Society for Participatory Medicine, "a movement in which networked patients shift from being mere passengers to responsible drivers of their health" and in which professional health care providers encourage "empowered patients" and value them as full partners in managing their health and wellness.

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