I was troubled by some of the network TV news coverage I saw about former Vice President Dick Cheney getting a left ventricular assist device. So I turned to a journalist who knows a lot about such issues – Mary Knudson, co-author with Edward K. Kasper M.D. of Living Well with Heart Failure, the Misnamed, Misunderstood Condition. Here are Mary’s comments:
The main problems I saw with coverage of former Vice President Dick Cheney getting a device implanted to treat his worsening heart failure was absence of reporting about the huge risks associated with this procedure. Below are some points to include in balanced reporting about an LVAD:
A left ventricular assist device (LVAD) can be an effective means of treating heart failure short term, but is much riskier and more complex than implanting a pacemaker. The LVAD is a pump that does the work for a weak left ventricle, removing blood from the left ventricle and pumping it into the aorta where it then flows to the rest of the body. The newer model smaller pump is implanted in the chest and has tubes leading to the left ventricle and aorta and another that goes outside the body to connect to a computerized controller. The controller can be worn on the waist and operated by batteries. The LVAD is used in people with heart failure that is so severe, medications do not prevent shortness of breath and fatigue. The device is used in someone with end-stage heart failure as a bridge to keep a person alive until he can get a heart transplant or as a final treatment that may prolong his life up to 10 months to two years or sometimes longer.
While the LVAD can dramatically improve the quality of a person’s life by relieving the symptoms that prevent activity, it is a procedure that carries a great deal of risk. Death can occur during the procedure, in the first few days after it, or after the person returns home. Risks include infection, blood clots, bleeding, device failure, and quite a few others.
Using the newest model of LVAD, a person can go about daily activities by carrying with him a couple of sets of battery replacements and then at night connecting the LVAD to a laptop computer that is plugged in to an electrical outlet. Or the person might work at an office or at home with the LVAD plugged through the computer to an electrical outlet. The LVAD has come a long way from the noisy large stationary power sources patients were tethered to. Newer units are smaller, portable for hours, and quieter. But the risks are the same and this device is used as a last resort.
The TalkingPointsMemo site did focus on the potential harms and risks. And a TPM reader submitted this comment:
“I’m a surgeon and just read your wire story about Dick Cheney getting a Left Ventricular Assist Device (LVAD) placed. The story downplays the seriousness of that procedures…once you’ve got an LVAD in place, it means your heart is essentially incapable of working on its own and has no potential to improve. While LVAD outcomes have been improving, and some patients live months or even years with one of these devices in place, this is a HUGE operation with MAJOR associated morbidity and mortality. If he’s not listed for a heart transplant, his days are seriously numbered. Life on an LVAD isn’t something I’d wish on my worst enemy…an axiom that this situation really tests. He’s in for a rough time.”
Exaggerating potential benefits and minimizing potential harms is a troublesome trend in health care news – something we’ve documented on HealthNewsReview.org.
It’s ironic that the Cheney LVAD story occurred on the same day the New York Times ran a relatively unquestioning piece about a French artificial heart device. Scrutiny of the evidence for medical devices – big or small – is an important area of improvement for health care journalists.