Contrast DeFelice’s story with that of 63-year-old Chris Einhorn. Three decades after DeFelice’s transplant, Einhorn was out drinking coffee at a Starbucks in Rockville when Johns Hopkins called to say her new heart was ready for her. That night she underwent surgery, and she left the hospital nine days later. Soon she was on her feet and playing with her grandson.
DeFelice and Einhorn are both success stories. But Einhorn was in relatively good health when she received her transplant, because for the previous 17 months her native heart had been getting a boost from a left ventricular assist device, or LVAD — a machine that has transformed prospects for patients with serious congestive heart failure. Increasingly, such devices sustain people, including most notably former vice president Dick Cheney, who probably would have died before they could receive a transplant. And the support the devices provide often allows patients to recover faster after they do get a new heart. DeFelice, without use of an LVAD, had to spend a month in the hospital after his transplant.
As many as 500,000 people suffer heart failure in the United States each year. Yet the number of hearts available for transplant plateaued at around 2,500 in 1995. Medicine is getting better at transplanting hearts and the need for them is growing larger, but the number of organs available is static. So devices are filling some of that gap.
“The whole field is being dominated today and tomorrow by LVAD and artificial hearts, and is becoming a problem of engineering, miniaturization and, believe it or not, batteries,” says cardiologist Michael Hess , who directs the Pauley Heart Center’s heart transplantation program — one of the world’s oldest — at the Medical College of Virginia in Richmond. “The next big breakthrough is going to come out of [engineering schools such as] MIT and not medicine.”
He adds: “We can now take someone near death’s door, put in a mechanical device, rehabilitate them over several months and improve their state of health, so that when they do have the transplant, they are in much better shape.”
That was what happened to Cheney, who was indeed at death’s door, his heart and kidneys failing, in July 2010, when he was rushed into surgery to receive an LVAD. It restored his health to the point that he was able to receive a heart transplant 20 months later, at age 71.