Evidently, the man no longer has a pulse, thanks to the new $200,000 continuous-flow Left Ventricular Assist Device (LVAD, image here) that Americans have generously purchased for the vasculopathic former VP. For the chronic gambler in your family, the following information may or may not be relevant:

Dr. [O.H.] Frazier [who did not perform Cheney’s implant] said he had implanted a total of 170 such pumps as of June 1, more than any other surgeon. Of those, 24 were in patients 65 and older and 11 of the 24 were in patients older than 70. The oldest was 76. Nine of the 24 have died, and seven of the nine did not leave the hospital. Six of the 15 survivors received heart transplants. The remaining nine are living with the pump. The longest survivor at his hospital had an implant in his 30s and has lived five and a half years.

Cheney’s options at this point are:

Live with the new pump forever, so to speak. Throw his 69-year-old name into the pool for a human heart transplant.

A randomized trial in the New England Journal of Medicine recently put the odds of surviving 2 years with a continuous-flow LVAD at about 58 percent. European researchers have found similar results, with one study finding that nearly 70 percent of patients last until “transplantation, recovery or ongoing device support” (though the results of that paper are a little trickier to interpret, since a significant percentage of patients received a device within 6 months of the study’s conclusion.) Best I can tell from scanning the published research, most patients receive an LVAD (continuous-flow or pulsatile) with every intention of eventually receiving an actual heart transplant, though it’s not uncommon for LVADs to be used as “destination therapy” (i.e., a permanent fix).

And in case anyone is wondering, if Cheney did eventually receive a transplant, the organ would come from the Extended Criteria/Alternate Donor list, which means he wouldn’t be redirecting one from the waiting chest cavity of a 20-year-old. Though he’d probably do that if he could. Actually, what I wrote earlier doesn’t seem to be entirely correct; the use of EC-AD lists seems to depend on the center doing the transplant. Regardless, it looks like Cheney would likely be a terrible candidate for a new heart mainly due to his age; the upper limit for those seems to be around 72 years old, and given Cheney’s history of health problems (including kidney malfunctions, aneurysms in his knees, high cholesterol, hot dog fingers, etc.), it would take an especially optimistic surgeon to see Cheney lasting more than a few months with a new heart (and even less so for one drawn from an extended criteria list).

Even so, if/when Cheney croaks on Obama’s watch, we can look forward to a whole new species of wingnut paroxysm.



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