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Aide says Dick Cheney had heart transplant

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By Kasie Hunt
Associated Press
WASHINGTON — Former Vice President Dick Cheney, a 71-year-old with a long history of cardiovascular problems, had a heart transplant Saturday and is recovering at a Virginia hospital. Not even Cheney knows the donor's identity.
An aide to Cheney disclosed the surgery after it was over, saying that the ex-vice president, who suffered five heart attacks over the years, had been waiting for a transplant for more than 20 months.
“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,” aide Kara Ahern said in a written statement that was authenticated by several of the Republican politician's close associates.
More than 3,100 Americans currently are on the national waiting list for a heart transplant. Just over 2,300 heart transplants were performed last year, according to the United Network for Organ Sharing. And 330 people died while waiting.
According to UNOS, 332 people over age 65 received a heart transplant last year. The majority of transplants occur in 50- to 64-year-olds.
Cheney was recovering Saturday night at the intensive care unit of Inova Fairfax Hospital in Falls Church, Va., after surgery earlier in the day.
The odds of survival are good. More than 70 percent of heart transplant recipients live at least five years, although survival is a bit lower for people over age 65.
The former vice president suffered a heart attack in 2010, his fifth since the age of 37.
That same year, he had surgery to have a small pump installed to help his heart keep working.
Called a “left ventricular assist device,” or LVAD, that device took over the job of the heart's main pumping chamber, powered by special batteries worn in a fanny pack. It helps a person live a fairly normal life while awaiting a heart transplant, although some people receive it as permanent therapy. It was one of the few steps left, short of a transplant, to stay alive in the face of what he acknowledged was “increasing congestive heart failure.”
In January 2011, Cheney said he was getting by on the battery-powered heart pump, which made it “awkward to walk around.” He also said he hadn't made a decision yet on a transplant, but that “the technology is getting better and better.”
Cheney said then that he'd “have to make a decision at some point whether I want to go for a transplant.”
By that point, Cheney had been dealing with cardiovascular problems for more than two decades.
In 1988, he had had quadruple bypass surgery, and had two artery-clearing angioplasties and the operation to implant a pacemaker, a device that monitored his heartbeat.
In 2005, Cheney had six hours of surgery on his legs to repair a kind of aneurysm, and in March 2007, doctors discovered deep venous thrombosis in his left lower leg. An ultrasound a month later showed the clot was getting smaller.
In July 2007, he had had a minor surgical procedure to replace the pacemaker.
Cheney served as former President George W. Bush's vice president for eight years, from 2001 until 2009. Cheney was a lightning rod for criticism during Bush's presidency, accused by opponents of often advocating a belligerent U.S. stance in world affairs during wars in Iraq and Afghanistan.
Like 5 million other Americans, Cheney had congestive heart failure, meaning his heart had become too weakened to pump properly. That can happen for a variety of reasons, but Cheney's was due to cumulative damage from his multiple heart attacks.
Heart failure kills 57,000 Americans a year and contributes to many more deaths.
Shortly after Cheney's surgery was disclosed, one prominent cardiologist — Dr. Eric Topol of Scripps Health in La Jolla, Calif. — raised the issue of whether someone so old should have received a new heart.
“The ethicists will get into this case,” he wrote on Twitter.
Others disagreed.
“It is not too old. Age is really not a factor,” said Dr. William Zoghbi of Methodist Hospital's DeBakey Heart and Vascular Center in Houston. He is incoming president of the American College of Cardiology, and he spoke from the group's annual conference in Chicago on Saturday.
Zoghbi said Cheney may even fare better than younger people whose immune systems more actively fight new organs, raising concern about rejection.
“I don't see any ethical issues here,” Zoghbi said, because a transplant is clearly indicated for someone whose heart is as weak as Cheney's was.
A heart transplant is a race against time. Doctors look to the waiting list for the next qualified candidate who is a good match to the newly donated heart, which typically comes from an accident victim. The patient must get to the operating room quickly, as a newly donated heart stays fresh for only about four to six hours.
During a heart transplant, a mechanical pump keeps blood flowing through the body while surgeons remove the diseased heart — and in Cheney's case, the previously implanted LVAD — and connect the new one.
Patients must take immune-suppressing medication for life, to keep their body's immune system from attacking the new, foreign organ. They typically stay in the hospital for a week or two, and require intensive cardiac rehabilitation.
Associated Press writers Nancy Benac and Will Lester and AP Medical Writer Lauran Neergaard contributed to this report.
Cheney's history of heart problems
1978: Cheney’s first heart attack, at age 37.
1984: Second heart attack.
1988: After a third heart attack, Cheney has quadruple bypass surgery in August to clear clogged arteries.
November 2000: Cheney has what doctors called a “very slight” heart attack, his fourth. He has an angioplasty to open a clogged artery. After this heart attack, Cheney begins a daily 30-minute regimen on the treadmill and eating healthier. He takes medication to lower his cholesterol. He quit smoking in 1978.
March 2001: Just over 100 days later, Cheney feels chest pains and has another angioplasty to reopen the same artery.
June 2001: Cheney returns to the hospital and has a special pacemaker, an implantable cardioverter defibrillator, or ICD, inserted into his chest. During his 2004 annual checkup, doctors say the device never has activated automatically to regulate, which they say means the heart is functioning normally.
November 2004: Cheney enters the hospital after complaining of shortness of breath. He leaves after three hours. An aide says tests find no abnormalities.
September 2005: Cheney has surgery to repair an arterial aneurysm on the back of each knee.
—January 2006: Cheney experiences shortness of breath and goes to the hospital. The problem is attributed to fluid retention as a result of medication he was taking for a foot ailment. He is placed on a diuretic and released.
July 2006: His annual physical shows the pacemaker is working properly and his overall heart condition. A stress test on a treadmill is scheduled for the fall.
June 2007: His annual physical reveals no new blockages in his heart, but doctors say he needs a new battery for a special pacemaker he has in his chest.
November 2007: Doctors administered an electrical shock to Cheney’s heart and restored it to a normal rhythm during a 2 1/2 hour hospital visit. Cheney was discovered to have an irregular heartbeat when he was seen by doctors at the White House for a lingering cough from a cold. He remained at work throughout the day before going to the hospital. The irregular heartbeat was determined to be atrial fibrillation, an abnormal rhythm involving the upper chambers of the heart.
July 12, 2008: Doctors reported that Cheney’s heartbeat was normal for a 67-year-old man with a history of heart problems. At his annual checkup, he also had an electrocardiogram, a test that detects and records the electrical activity of the heart, and imaging of the stents placed in the arteries behind his knees in 2005. Doctors found that Cheney had not experienced any recurrence of atrial fibrillation and the special pacemaker had neither detected nor treated any arrhythmia, a problem with the heartbeat’s speed or rhythm.
July 28, 2007: He has surgery to replace an implanted device that monitors his heartbeat. Doctors replaced the defibrillator, a sealed unit that includes a battery. They did not replace the wiring attached to the defibrillator. The wires thread through Cheney’s heart and replacing them would have required a much more extensive operation.
February 2010, Cheney suffers his fifth heart attack.
July 2010, Cheney underwent surgery to install a small pump to help his heart work, as he entered a new phase of what he called “increasing congestive heart failure.”
March 2012, Cheney has a heart transplant and is recovering at a Virginia hospital. He had been waiting for a transplant for more than 20 months.
Story tags » HealthHealth treatment

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