FRIDAY, JULY 16, 2010
KLMNO POLITICS THE NATION & Pump found to extend heart patients’ lives How Cheney’s heart device works
CHENEY’S TECH OPTION
Device can be
‘bridge’ to transplant by David Brown
If former vice president Rich- ard B. Cheney’s experience is similar to that of other patients who have heart pumps implant- ed, he has a better than 50-50 chance of surviving two years. The device, which takes over the work of the heart’s main pumping chamber, should less- en discomfort and allow Cheney to do activities as strenuous as riding a bicycle. But it is far from a miracle cure for end- stage congestive heart failure, the condition from which he ap- parently suffers. Cheney, 69, had a left ventric- ular assist device implanted last week at Inova Fairfax Heart and Vascular Institute. In a state-
ment Wednesday, Cheney said he was “entering a new phase of the disease . . . and decided to take advantage of one of the new technologies available.” He has not made public key
details of his treatment, includ- ing the exact type of device he received. It is not known wheth- er a heart transplant is being considered. But experts on heart failure and published studies of ventricular assist de- vices sketch a general picture of his prognosis. It is likely he received a
HeartMate II LVAD, made by the California company Thora- tec, which is approved as either a “bridge to transplantation” or as “destination therapy,” which is permanent use. It is an elec- trical device implanted in the chest that draws blood from the left ventricle and pumps it into the aorta, the main artery leav- ing the heart. A study published in Decem- ber showed that 58 percent of patients who received the HeartMate II were alive two years later. Forty-six percent were alive, had not had a stroke
(the chief complication) and had not needed a replacement. Patients with a different Tho-
ratec device — one that pumps the blood in pulses, like the heart, rather than continuously — did much worse, the study found. Twenty-four percent sur- vived two years, and nearly all of them had had their devices replaced during that period. The prognosis for people with end-stage congestive heart fail- ure who get neither a trans- plant nor a pump is dismal. In a previous study, it was 8 percent after two years. “We have taken a disease that had a terrible prognosis and given people a much improved prognosis and a better quality of life,” said Samer Najjar, a car- diologist who heads programs on heart failure, heart trans- plantation and mechanical cir- culatory support at Washington Hospital Center. The procedure to implant a pump normally requires a three-week hospital stay. A thin power cord runs from an ex- ternal battery pack, which can be carried over the shoulder,
through the abdomen to the pump. Infection is a constant risk. The main hazard, however, is the formation of blood clots in the pump circuit. A clot can travel to the brain and cause a stroke. For that reason, people with pumps must take anticoag- ulant drugs. The devices solve the prob- lem of life-threatening left ven- tricle failure, but they do not help the right ventricle. That chamber is responsible for pumping blood to the lungs, where oxygen is picked up and carbon dioxide is released. In some patients, the right ventri- cle is so weak that it eventually fails, too.
Other causes of death in peo- ple with heart pumps are kid- ney failure, liver failure and res- piratory failure, Najjar said. About 4,000 people world- wide have received HeartMate II devices, which cost $100,000, said Thoratec spokeswoman Su- san Benton Russell. Cheney has had five heart at- tacks, the first when he was 37.
browndm@washpost.com
DIGEST CRIMINAL JUSTICE
Former Democratic fundraiser sentenced
PETER R. BARBER/SCHENECTADY DAILY GAZETTE VIA ASSOCIATED PRESS
A firefighter kneels to the ground as a fire rages through an old factory filled with books early Thursday in Amsterdam, N.Y.
A wealthy Manhattan invest- ment banker and former top Democratic fundraiser was sen- tenced Thursday to 12 years in prison for defrauding banks of $292 million, some of which he donated to politicians including Barack Obama, Hillary Clinton and Al Gore. Hassan Nemazee, 60, had reached a plea deal in March, ad- mitting that he cheated banks and pleading guilty to three counts of bank fraud and one count of wire fraud. U.S. District Judge Sidney Stein in Manhattan said Nemazee will get out of pris- on in about a decade. Nemazee was the national fi- nance chairman of Clinton’s 2008
presidential campaign; he also raised money for Obama and a long list of other prominent Dem- ocrats. He was Sen. John F. Kerry’s
New York finance chairman dur- ing his failed 2004 presidential run. Prosecutors said he used some of the proceeds from his crimes to make personal donations to elec- tion campaigns, to make charita- ble donations and to live a lavish lifestyle that included apart- ments in Italy and Manhattan, partial ownership of a private plane and a luxury yacht. — Associated Press
Sheik’s lawyer faces more prison time
A 70-year-old civil rights law- yer was sentenced Thursday to 10
years in prison by a judge who boosted the original sentence by nearly eight years after conclud- ing that the lawyer lied to a jury and lacked remorse. The sentence was nearly four times as long as the two-year, four-month term Lynne Stewart originally received from U.S. District Judge John G. Koeltl in 2006. She was convicted of let- ting a jailed Egyptian sheik communicate with his followers despite restrictions to prevent it.
An appeals court had ordered
a new sentencing, saying that the terrorism component of the case needed to be considered, along with whether Stewart committed perjury at her trial. The court said it had “serious doubts” whether her original sentence was reasonable. Koeltl said that comments
Stewart made after her first sen- tencing showed him that the “original sentence was not suffi- cient.” He said she showed “a lack of remorse for conduct that was both illegal and potentially le- thal.”
— Associated Press
Bloomberg’s election spending tops $109 million: New York Mayor Michael R. Bloomberg (I) spent $109.2 million on his win- ning bid for a third term — more than 11 times the total of his Dem- ocratic opponent, who lost by a margin of less than five percent- age points. The total amounts to the most expensive self-financed bid for office in U.S. history. The billionaire mayor’s campaign filed its final spending report Thursday with the state Board of Elections.
— Associated Press
Two rechargeable batteries, often worn on shoulder straps, power the pump and system controller. Batteries must be replaced within minutes of a low-battery alarm, so users must always carry spares.
The system controller regulates motor speed and power, monitors blood flow, sends alarms and data to
a stationary module at the patient’s home and stores data to upload to a system monitor at the hospital.
SOURCES: Thoratec, Washington Hospital Center
A left ventricular assist device pumps oxygen-rich blood through the heart to the rest of the body.
Former vice president Richard B. Cheney’s pump is probably similar to this one. The pump works like a jet engine, speeding several liters of blood per minute from the apex of the left ventricle through the ascending aorta. A cable runs from the pump through an incision in the abdomen to an external controller.
Ascending aorta
S
A3
o
v Left
entricle Pump
d
BONNIE BERKOWITZ AND TOBEY/THE WASHINGTON POST
Tanlines fade.AMercedes-Benz lastsforever. The Mercedes-Benz Summer Event.
MBUSA.com/SummerEvent The Summer Event
Take to the roads this summer in the expertly engineered Mercedes-Benz you’ve always wanted. Come in to the Mercedes-Benz Summer Event now and get exceptional offers on the exhilaratingly efficient C300 Sport Sedan; the smart, spacious GLK; the safety-award-winning M-Class; or the stunning E-Class, one of the most advanced luxury sedans on the planet. But hurry—the cars are made to last, the offers are not. See your authorized Mercedes-Benz dealer today.
MBUSA.com/SummerEvent
$689
The 2010 E350 Sport Sedan *
$689 FIRST MONTH’S PAYMENT $1,675 CAPITALIZED COST REDUCTION $795 ACQUISITION FEE
FOR A 39 MONTH LEASE $3,159 CASH DUE AT SIGNING Now through August 2, 2010
Visit your local Mercedes-Benz Dealer for a test drive today. Authorized dealership locations in:
Alexandria • Arlington • Bethesda • Chantilly • Fredericksburg • Germantown • Hagerstown • Silver Springs • Vienna
Vehicles may be shown with optional equipment. *Available only to qualified customers through Mercedes-Benz Financial at participating dealers through August 2, 2010. Not everyone will qualify. Advertised 39 month lease payment based on MSRP of $53,425 less a suggested dealer contribution resulting in a total gross capitalized cost of $52,080. Dealer contribution may vary and could affect your actual lease payment. Includes destination charge, automatic transmission and Premium 1 Package. Excludes title, taxes, registration, license fees, insurance, dealer prep and additional options. Total monthly payments equal $26,871. Cash due at signing includes $1,675 capitalized cost reduction, $795 acquisition fee and first month’s lease payment of $689. No security deposit required. Total payments equal $29,341. At lease end, lessee pays for any amounts due under the lease, any official fees and taxes related to the scheduled termination, excess wear and use plus $0.25/mile over 32,500 miles and a $595 vehicle turn-in fee. Purchase option at lease end for $30,452 plus taxes (and any other fees and charges due under the applicable lease agreement) in example shown. **Rate applies only to select Mercedes-Benz Model Year 2010 vehicles. 1.9% APR financing for 24 months at $42.50 per month, per $1,000 financed or 1.9% financing for 36 months at $28.60 per month, per $1,000 financed. Excludes leases and balloon contracts. Must take delivery of vehicle by August 2, 2010. Not all buyers will qualify for special financing. See your authorized Mercedes-Benz dealer for complete details on this and other finance offers. ©2010 Authorized Mercedes-Benz Dealers
For more information, call 1-800-FOR-MERCEDES, or visit
MBUSA.com/SummerEvent.
1.9
** %
APR FOR 24 TO 36 MONTHS
B
w
l
o
o
f l
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92 |
Page 93 |
Page 94 |
Page 95 |
Page 96 |
Page 97 |
Page 98 |
Page 99 |
Page 100 |
Page 101 |
Page 102 |
Page 103 |
Page 104 |
Page 105 |
Page 106 |
Page 107 |
Page 108 |
Page 109 |
Page 110 |
Page 111 |
Page 112 |
Page 113 |
Page 114 |
Page 115 |
Page 116