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Cheney and His LVAD

Yesterday it was announced that former vice president Dick Cheney received a left ventricular assist device (LVAD).  A LVAD is designed to help patients with end-stage congestive heart failure (CHF). 

CHF occurs when the pumping capacity of the heart is diminished to the point where there is insufficient blood flow to the body.  CHF can result from a number of causes.  It most commonly occurs when blockages in the heart arteries cause damage to heart muscle.

After the onset of CHF, the condition is usually progressive. Up to a certain point, patients can be treated with oral medicines and life-style modification. However, after a certain point, oral medications cannot help the heart pump enough blood to the body. This is called end-stage congestive heart failure. At this point patients have three options:

  1. Intravenous (IV) medications which temporarily help heart muscle function
  2. Heart transplant
  3. A left ventricular assist device.

IV medications are not effective long term, and can actually make heart failure worse in some cases.  A heart transplant is the ultimate treatment for end-stage heart failure. However, finding an appropriate donor takes time. Until a transplant is available, a LVAD can help the heart pump blood to the body. 

L VAD’s are not new, and have been around for more than a decade.  These devices were initially large and required constant monitoring, and patients with LVADs were prone to life-threatening complications. However, technology has steadily improved, and the quality of life for patients with LVADs has improved along with these technological advancements. 

Studies have shown that patients who have end-stage heart failure live longer and have a better quality of life with an LVAD than without.  In fact, LVAD’s are now often used not just as a bridge until a heart transplant, but as a long-term solution by themselves, known as destination therapy.

Mr. Cheney has ischemic cardiomyopathy (damage to heart muscle due to blockages in the arteries).  These blockages have caused five heart attacks, the first of which was when he was 37 years old.

To treat these blockages, he has undergone bypass surgery and stenting procedures. However, his heart is now damaged to the point where he has end-stage CHF. To treat this, he has received a LVAD. It remains possible that he may need a heart transplant in the future.

Dr. Ravish Sachar is a cardiologist with Wake Heart & Vascular Associates and perfoms many procedures in the WakeMed Heart Center.

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