But should he get a new one?

Dick Cheney’s heart troubles have been well-documented. Now comes the news that the former Vice President is considering a heart transplant.  On January 30th he turns seventy, an age at which most transplant programs in the U.S. consider patients too old for the rigors of transplant surgery.

A markedly thinner Cheney has started appearing in public again.

Currently, Cheney’s life depends on an artificial pump known as a left ventricular assist device (LVAD). LVADs (pronounced “EL-VADS”) have only been in mainstream clinical use for the last fifteen years. They are an adaptation of heart-lung bypass machines, used for decades in coronary artery bypass surgery. Cardiothoracic surgeons realized that damaged hearts could themselves be bypassed to keep patients alive while awaiting a new pump–either the mechanical kind (an “artificial heart,” still a work in progress) or a heart from a cadaveric donor. Over the years, LVADs have been refined to the point where they weigh only 500 grams (slightly more than a pound) and can safely be powered by external batteries. Consequently, patients with LVADs are now able to move around freely and leave the hospital, unlike the early days of assist devices, when patients were literally tethered to the wall.

An LVAD is placed under the skin of the abdominal wall (in front of the stomach), with its blood entry port inserted into the heart’s left ventricle, and the exit spout directed into the aorta, the body’s main blood vessel. The LVAD’s power wire (about the thickness of your pinkie, called a “drive line”) tunnels from the device under the skin of the abdominal wall, and out the right side of the abdomen where it’s connected to a battery. When at home, a patient like Cheney needs to always be vigilant to charge his batteries so that he can have adequate range. The batteries are worn externally, ideally tucked in the pockets of a garment like a hunting vest.

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