Cheney transplant puts spotlight on heart failure treatments
Former United States vice president Dick Cheney’s ongoing recovery from a long awaited and “lifesaving” heart transplant, combined with his 20-month survival after receiving the HeartMate II — a left ventricular assist device (LVAD) — has rekindled interest in interventions that can extend the lives of patients with advanced heart failure.
Doctors interviewed by MedPage Today, Reuters, Agence France Presse, Associated Press and the New York Times all agree that Cheney’s situation has enhanced public awareness of advanced heart failure and available treatment options.
“Cheney’s situation demonstrates that we can provide really great care for patients with advanced heart disease and it no longer needs to be considered a desperate situation,” Dr. Clyde Yancy, a past president of the American Heart Association (AHA) and chief of cardiology at Chicago’s Northwestern University told MedPage.
On March 24, the office of Cheney released a statement saying he was “recovering in the intensive care unit of Inova Fairfax Hospital in Falls Church, Virginia, after undergoing heart transplant surgery.”
“Although the former vice president and his family do not know the identity of the donor, they will be forever grateful for this lifesaving gift,” the statement added, without giving further details on his condition.
Cheney, 71, who served under former president George W. Bush, was in end-stage heart failure after suffering five heart attacks in his life. He had been on the waiting list of a new heart for 20 months.
Since his first attack in 1978 at age 37, Cheney’s care has run the range of interventions — ranging from coronary stents to keep blocked heart arteries open, a quadruple bypass surgery in 1988 to re-route blood flow around diseased arteries, an implant of a heart defibrillator in 2001 to safeguard against dangerous rhythms.
And in July 2010, when Cheney suffered his fifth heart attack, doctors implanted an artificial heart pump called a left ventricular assist device — or LVAD — used to take over the pumping function of a diseased heart for patients in end-stage heart failure.
Heart experts say the device offers a way to keep organ systems working well enough until a patient can accept a donor heart. VADs often serve as bridges to a transplant, they say, and Cheney agreed. Saying this was a “miracle of modern technology,” Cheney also said in a 2011 interview with NBC News that it was a “temporary measure.”
In his long political career, Cheney served in Congress, the White House and as defense secretary. But it was as vice president that he gained prominence. He was a central figure in the “war on terror” launched by the U.S. in the wake of the September 11 terror attacks.
He was seen as “dark and heartless — the Darth Vader of the administration,” because under his watch, controversial measures were allowed: the use of harsh interrogation methods that met global definitions of torture and the wiretapping of U.S. citizens without a warrant. Cheney was also heavily involved in the subsequent decisions to invade Afghanistan in 2001, and Iraq in March 2003.
Cheney as VAD poster boy
Now he’s the “face” of heart failure interventions.
Cardiologist Dr. Yancy thinks that Cheney’s recent heart transplant provides a needed opportunity to make people aware of the existence of effective treatments for heart failure — medical therapies, implantable cardioverter-defibrillators, revascularization procedures, ventricular assist device (VADs) and transplant.
Cheney’s survival shows that the time has come to consider VADs as part of the treatment strategy, Dr. Yancy says.
By receiving the mechanical assist device and talking about it, Cheney “changed people’s perception of the therapy,” says Dr. Mary Norine Walsh, spokesperson for the American College of Cardiology and Medical Director of the Cardiac Transplant Patient Program at St. Vincent Heart Center in Indianapolis.