KEY POINTS:
Stephen Delaney, lying perilously ill in Auckland City Hospital with heart failure, is desperate to survive for his 8-year-old son Joseph.
Mr Delaney had his first heart attack nearly three months ago and now faces death within a year unless he has risky surgery.
He wants a heart transplant. But, mainly because of New Zealand's low number of organ donors - 38 last year - his doctors have recommended a different operation, one designed to increase the pumping power of his damaged heart.
Tears come to Mr Delaney's eyes when he talks of Joseph, whose face has been tattooed on his left shoulder.
"He is my life. I've raised him alone since he was 2."
Mr Delaney, 32, a domestic purposes beneficiary and a former book and stationery shop manager, was living in Whangamata when he became ill.
He has been in and out of various hospitals since, and was admitted to Auckland City Hospital on November 12.
He said hospital staff had acknowledged they had not offered a transplant because of his history of alcohol and drug abuse, which he had told them about.
He said he was a big P user, but gave it up seven years ago. He was a very heavy drinker until a year ago, but after seeking help had cut down before his heart attack. And he had not smoked for a month.
"I wish I had lied and said I never touched drugs, that I never had a problem with drink - maybe that would have come up through the system but with the outcome I've got now it would have been worth the risk."
But his cardiologist, Dr Peter Ruygrok, said Mr Delaney's drug and alcohol history was only a minor consideration.
Heart transplants were rare in New Zealand because of the small number of donors and the need to match blood group and body weight.
Only eight had been done this year by the national heart and lung transplant service in Auckland. The clinicians who considered Mr Delaney's case feared that if he was put on the transplant waiting list he might die before a suitable heart became available.
"He wouldn't be here in a year's time," Dr Ruygrok said.
Implanting a mechanical device to help his heart pump more blood around his body was ruled out because of the low success rate with this operation. Three of the six people treated this way in New Zealand had died before their transplant.
The clinicians believe Mr Delaney's risk is reduced if he receives conventional surgery - left ventricular reduction - than if he waits for a transplant.
This operation involves removing some of the heart tissue, enabling the muscle to pump out more blood.
Dr Ruygrok said patients could lead a reasonably normal life after this operation.
Like any heart surgery, it carried risks of heart attack, stroke and death, but they were "much better than the 50/50 chance of the ventricular assist device getting him through".
