March 26, 2012 -- The pump that kept Dick Cheney's blood flowing while he waited for a heart transplant has seen a surge in popularity, a trend credited in part to the 71-year-old's successful 20-month stretch with the device.
"The reality is that many patients have come to us asking about the 'Cheney pump,'" said Dr. Robert Kormos, director of the Artificial Heart Program at the University of Pittsburgh, referring to the Left Ventricular Assist Device or LVAD that pumped Cheney's blood on behalf of his failing heart. "His positive presentation while on the device has very much been positive for the public impression of the therapy."
For Cheney, the Left Ventricular Assist Device or LVAD was a bridge therapy, a temporary fix while the former vice president climbed a lengthy transplant waiting list. Cheney received his new heart Saturday at a hospital in Falls Church, Va. But for some patients, the device is a long-term solution to heart failure, a condition that kills 300,000 Americans each year.
"There is no doubt that more and more patients are doing well [on LVADs] for long periods of time," said Dr. John Byrne, chair of cardiothoracic surgery at Vanderbilt University Medical Center in Nashville. Unlike bridge therapy, "destination therapy" keeps patients on an LVAD indefinitely. "In my mind, the distinction between destination therapy and bridge therapy is becoming less important. I suspect VP Cheney's successful transplant will add to the enthusiasm for [L]VAD therapy as a viable long-term option for many patients with severe cardiac failure."
Experts say Cheney's 20-month stint with an LVAD is average or slightly longer than usual for someone awaiting a heart transplant. But some patients have lived with the device for several years.
"We have a destination therapy patient who has survived eight years," said Dr. Keith Aaronson, medical director of the Heart Transplant Program and Center for Circulatory Support at the University of Michigan in Ann Arbor. "Of course, Mr. Cheney's experience puts LVAD in the public consciousness in a way that other patient's successes can't."
Cheney's success might also prompt heart failure patients to consider an LVAD earlier on.
"Regardless of the circumstances that led to [Cheney] being transplanted at this time rather than staying on the LVAD permanently, his favorable LVAD experience has been confidence-building and will likely lead to greater use of LVADs," said Dr. Timothy Gardner, medical director or the Center for Heart & Vascular Health at Christiana Care Health System in Newark, Del. "In particular, it is likely that LVAD implants will be performed a bit earlier in the course of a patient's heart-failure deterioration."
But long term use of LVADs comes with risks. The open-heart procedure to implant the device can cause life-threatening bleeding or infection, according to the Mayo Clinic. And after the LVAD is successfully implanted, blood can clot inside the device. Patients are sometimes prescribed blood-thinners, which also carry risks. There's also a chance the battery-operated machine could stop working.
"VP Cheney's LVAD was not used as destination therapy; it was used as a bridge to transplantation," said Dr. William Abraham, MD, director of cardiovascular medicine at Ohio State University in Columbus, who was not involved in Cheney's care. "That said, his case does demonstrate good outcome on an LVAD over 20 months and supports the use of LVADs for end-stage heart failure. This is well supported by the LVAD trials and we are seeing a steady increase in LVAD use."
"The greater awareness of LVADs because of VP Cheney should drive further growth," Abraham added."I do have patients that inquire about getting the type of device he had."