Vice President Dick Cheney: In Need of Heart Transplant?

VIDEO: Dr. Richard Besser explains how age and history factor into the decision.
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After a lengthy recovery period following heart surgery last summer, former Vice President Dick Cheney has quietly and slowly re-emerged in public. He attended several holiday cocktail parties and planned to attend an event marking the 20th anniversary of the Persian Gulf War, the New York Times reports. The Times said that at several holiday receptions in Washington last month, a "noticeably thinner" Cheney chatted about the heart pump he had implanted last summer to treat his recurring heart disease.

"At one cocktail party, the former vice president even opened his coat jacket to show it off," the Times reported.

Cheney's office did not immediately respond to a request by ABC News for comment. The former vice president underwent the procedure last July after it became clear, he said at the time, that he was "entering a new phase of the disease" when he began to "experience increasing congestive heart failure."

"After a series of recent tests and discussions with my doctors, I decided to take advantage of one of the new technologies available and have a Left Ventricular Assist Device [LVAD] implanted," Cheney said in his statement then.

The LVAD is implanted next to the heart to help its main pumping chamber, the left ventricle, pump blood through the body. Such devices are used mainly for short periods, to buy potential transplant candidates time as they await a donor organ.

Cardiologists said that in Cheney's case, the pump was likely a "bridge" that would keep him alive until he could receive a heart transplant. Many cardiac experts said at the time of his surgery that Cheney may be only one step away from a transplant but could find himself on a wait list for "months or years."

"The HeartMate II is used in situations where the patient's native heart continues to pump, but not normally and effectively," said Dr. Timothy J. Gardner, a heart surgeon at Christiana Care Health System in Wilmington, Del., and past president of the American Heart Association. "But it's enough to have some detectable pulse," he said.

"It's a really good strategy," said Dr. William Abraham, director of the division of cardiovascular medicine at Ohio State University, which performs 75 to 100 implantations a year.

"It's reserved for people who have end-stage heart failure, and advanced and heroic therapies have been tried, and after folks have optimized evidence-based and guideline-recommended drug therapies," he said. "Their heart conditions have progressed to a state where the mortality risk is very high and they turn to LVADs and transplants."

But many patients implanted with LVADs who do not seem to experience complications or need continuous intravenous medications to help the heart pump could afford to wait longer for a transplant, according to Dr. Gregory Crooke, cardiothoracic surgeon at Maimonides Medical Center in Brooklyn, N.Y.

"At this point in time, there probably is no difference between his survival over the next year with or without a heart transplant," said Crooke. "It may even be better without the heart transplant over the next year."

Given the LVAD device he received, it is likely Cheney may not yet have been placed as the highest priority on the transplant list, said Erika Feller, an assistant professor of medicine in the division of cardiology at the University of Maryland Medical Center.

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