Image: Dick Cheney
Harry Hamburg  /  AP
Former Vice President Dick Cheney has suffered five heart attacks.
By
NBC News and news services
updated 7/14/2010 8:32:06 PM ET 2010-07-15T00:32:06

Former Vice President Dick Cheney said Wednesday that he underwent surgery last week to have a tiny pump implanted to assist in the functioning of his heart as he experiences "increasing congestive heart failure.

The surgery, to insert a left ventricular assist device, was performed at Fairfax Hospital in Virginia.

Cheney, 69, has suffered five heart attacks, the first when he was 37. His most recent heart attack, described as "mild," was in February, but late last month he was admitted to George Washington University Hospital for a few days after reporting he was not feeling well. He received medication to treat a fluid buildup related to his aggressive form of heart disease.

"A few weeks ago, it became clear that I was entering a new phase of the disease when I began to experience increasing congestive heart failure," Cheney said in a statement. "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."

A doctor, who is part of his medical team, told NBC News that Cheney is "doing well now," but that the former vice president was short of breath and was experiencing "heart failure" before the device was implanted. He was "running on 3 cylinders. Now he's on 8," the doctor said.

The American Heart Association website defines the LVAD device as "a battery-operated, mechanical pump-type device that's surgically implanted. It helps maintain the pumping ability of a heart that can't effectively work on its own."

The kind of heart pump that Cheney received can be 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.

But they are being studied for use as a permanent therapy for people with severe heart failure who are not transplant candidates.

About 5 million Americans have congestive heart failure, where the heart weakens over time, often as a result of heart attacks, and cannot pump enough blood. Heart transplants are one solution, but few patients find a donor and many are too old or sick for transplants.

The heart pump Cheney received, known as an LVAD for short, is not a cure, said Dr. Samer Najjar, medical director of the heart transplant and LVAD division at Washington Hospital Center. But by rerouting the blood to take over the job of the left ventricle, the pump relieves pressure on the heart.

And once patients recover from the open-heart surgery, they can experience a much better quality of life, said Najjar, who had no firsthand information about Cheney's case.

The typical life expectancy of the recipient depends on whether the device is to be temporary and the person goes on to receive a heart transplant, or if the device is intended for permanent therapy. Recent studies suggest that 63 percent of patients who receive a permanent LVAD can survive two years, Najjar said. Those awaiting a heart transplant tend to have a slightly higher survival.

The details of Cheney's scenario were not immediately available.

This report from NBC News' Pete Williams and Steve Handelsman includes information from The Associated Press.

© 2013 msnbc.com

Video: Pump replaces Cheney's failed heart

  1. Transcript of: Pump replaces Cheney's failed heart

    MADDOW: we begin tonight with unexpectedly major news about the health of former vice president Dick Cheney . An episode of acute cardiovascular disease last week required Mr. Cheney to undergo an advanced surgical procedure. Now, the nature of the surgery has revealed unequivocally the severity of Mr. Cheney `s heart condition . And the entire event occurred without the real-time public awareness to which we have become so accustomed when it comes to the health of major public figures. In a statement today, the Cheney family revealed that Mr. Cheney underwent cardiac surgery last week in a northern Virginia hospital to combat congestive heart failure . Congestive heart failure means the heart can`t pump enough blood to the body`s other organs. Mr. Cheney `s surgery installed a small pump, called a left ventricular assist device which by battery power helps the heart `s main pumping chamber pump blood through the body. Included in the Cheney family press release was a statement from the former vice president himself, which read in part, "I have dealt with coronary artery disease for decades. A few weeks ago, it became clear I was entering a new phase of the disease when I began experiencing 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 implanted. The L -vad is a small implantable pump that improves heart function and will enable me to resume an active life ." Mr. Cheney has suffered coronary disease for more than 30 years. A minor heart attack as recently as February was his fifth since 1978 when he suffered his first at age 37. In late June, the former vice president was admitted to George Washington University Hospital in Washington after complaining of discomfort. That episode resulted in his receiving medication to treat a fluid buildup around his heart . But this latest episode is different. The installation of this Lvad , this device , it`s traditionally been a short to midterm treatment of heart failure , frequently used to sustain patients who require heart transplants. The American Heart Association `s website refers to this device as a bridge to transplant. That`s the way they put it. The device that Mr. Cheney received is being worn outside his body, like sort of a belly pack. His statement described the surgery as a success. He said that he is recuperating well. NBC News `s Steve Handelsman did additional reporting by speaking with a doctor involved with the former vice president`s care. That doctor told NBC News that Dick Cheney is doing well now, but that he was, quote, in heart failure before the surgery . The doctor describes Mr. Cheney as, quote, running on three cylinders. Now the doctor says he is running on eight. Dick Cheney is, of course, among the most significant and polarizing figures in modern American politics and policy. As always, we sincerely wish him good health tonight. To help us understand the former vice president`s current condition, Dr. Alan Stewart joins us now. Dr. Stewart is a cardiac surgeon and director of the Aortic Surgery Program at New York Presbyterian Hospital , Columbia University Medical Center . Dr. Stewart , thanks very much for being here.

    DR. ALAN STEWART, HEART SURGEON: Thank you for inviting me.

    MADDOW: I will guess that I got some of those basics, some of that explanation wrong. Did I get anything -- fuzz that at all?

    STEWART: Well, you had all the salient points right. A left ventricular assist device , this is an example of the device that Mr. Cheney has. It`s predominantly inside the body with the battery pack exiting through a small drive line that exits the belly. This ventricular assist device is quite small, as you can see, and it`s hooked up --

    MADDOW: Is this actual size?

    STEWART: That is actual size.

    MADDOW: Oh, my gosh, that doesn`t seem small.

    STEWART: It involves an inflow to the device , an impeller pump, which is a rotary pump that spins it about 8,000 to 10,000 rpms and an outflow to the body. It`s hooked up by coring a hole in the ventricle, shown here, which is a pumping chamber of the heart . This will be hooked up here. This pump would reside just at the top of the belly, and then would spin. It spins in a continuous manner to allow blood to be impelled into the aorta, which contains blood and which allows blood to be distributed to the rest of the body.

    MADDOW: So essentially a mechanical bypass to do the pumping motion that the heart in a healthy individual would do on its own?

    STEWART: Exactly.

    MADDOW: Okay. What are the implications for Mr. Cheney `s health to have this implanted? As far as I understand it, this is something that`s usually implanted on a short-term basis. Sounds like he`s intending on having it permanently in his body.

    STEWART: Well there are two options for a ventricular assist device . Bridge to transplant, which is a short-term device meaning that he would eventually get a transplant. And the reality is is that there is no indication for Mr. Cheney to have a transplant. The other option is that it can be something called destination therapy, meaning that this is his destination. This is his end result. He will have this ventricular assist device for the rest of his life.

    MADDOW: What does that mean for him, for the way he lives and his health?

    STEWART: You can have a pretty decent quality of life on a ventricular assist device . The devices are smaller now and they`re quite durable. This device could be expected to last for three to five years and then could even be changed out for another device .

    MADDOW: In terms of, when we were talking to you earlier about explaining what this means, one of the things you pointed out, which I think was -- it tells you an important point about how this works, is that Mr. Cheney won`t be expected to have, literally, a pulse .

    STEWART: A pulse . That`s true.

    MADDOW: He won`t have a pulse .

    STEWART: This is a continuous ventricular assist device , meaning that blood is impelled. It is not a pulsetile device . So if someone were to feel Mr. Cheney `s wrist, Mr. Cheney will have no pulse .

    MADDOW: Because it flows continuously like a garden hose instead of something that goes on and off. No pulse .

    STEWART: Exactly. The normal heart has an expansion and contraction, and that gives that bump bump, or two-beat pulse that we feel. It`s the valves closing. The valves will stay shut in his heart now and blood will flow in a continuous manner.

    MADDOW: Through that whirring motor that`s in the machine.

    STEWART: Correct.

    MADDOW: How common are devices like this and what does Mr. Cheney having one suggest to you about the seriousness of his condition?

    STEWART: Well, it means he`s at the end of his line as far as medical care . He had coronary surgery . He had percotanious stenting done. He had a pacemaker. He had medical management and failed all of those over the course of time . This was his last step. Either he would die of congestive heart failure or have a mechanical device inserted. It meant that he was quite ill at the time of his operation and didn`t have a long period of time to exist without a fatal event.

    MADDOW: It is shocking to hear the doctor describe him as being in heart failure at the time this was implanted. One last detail on this, it seems remarkable again for people who don`t know about these devices, like me, that this is worn -- part of this, the drive for this, as you say, is worn outside the body. Does Mr. Cheney have to wear this belly pack apparatus all the time now?

    STEWART: Absolutely. The device is powered by batteries, for six to eight hours outside to be untethered. And he`ll carry a number of battery packs, either in a handbag or in a harness which have become quite small and really not visible underneath the clothes. However, at nighttime, he`ll need to be hooked up into a power adapter into the wall.

    MADDOW: Wow. Without a pulse .

    STEWART: Without a pulse .

    MADDOW: The state of the technology is amazing. This is a strange way to learn it, and obviously, grave concern for Mr. Cheney `s health, but it`s fascinating. Dr. Stewart , thank you very much . I really appreciate your help with this.

    STEWART: Thank you.

    MADDOW: Dr. Alan Stewart is a cardiac surgeon , he`s the director of the Aortic Surgery Program at New York Presbyterian Hospital , Columbia University Medical Center . So