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Scar Tissue Removed From Clinton's Lung

By David Brown
Washington Post Staff Writer
Friday, March 11, 2005; Page A03

Former president Bill Clinton underwent a nearly four-hour operation yesterday to remove what was described as a "thick, rubbery, plaquelike . . . peel" from the surface of his left lung. His surgeons at New York-Presbyterian Hospital in New York pronounced the procedure a success.

"We expect full function recovery of that lung," said Joshua Sonett, the chest surgeon who performed the operation, at a news conference.

Joshua Sonett answers a question at New York-Presbyterian Hospital about the surgery he performed on former president Bill Clinton. (Photos Chip East -- Reuters)

_____From New York_____
Video: Former president Bill Clinton checks into a hospital to undergo more surgery on his chest.

Surgeons had planned to do the operation by making several small incisions between two ribs through which they would insert a fiber-optic videoscope and surgical instruments. But their initial inspection of the lung showed that the scar tissue was too extensive to be removed that way. Consequently, they did the operation "open" -- through a larger incision, with the ribs spread apart and the lung surface viewed directly.

The "pleural peel" -- the name for the thickened part of the pleura, or smooth membrane covering the lungs -- was nearly a quarter-inch thick in some places, according to the surgical team. Its size and toughness was one of the reasons the procedure took longer than the one to three hours originally predicted. There were no complications, however.

Clinton's condition is a rare complication of coronary artery bypass surgery, which he underwent on Sept. 6. Why it occurs is unknown.

Fluid accumulated around the base of his left lung, compressing it and reducing his breathing capacity by about 25 percent. It caused him slight discomfort while walking up hills, which he is doing as part of a post-bypass rehabilitation program, according to his doctors. It also made him somewhat winded.

The condition was not life-threatening. His doctors diagnosed it before he went to South Asia last month with former president George H.W. Bush to meet victims of the Dec. 26 tsunami and raise money for relief efforts.

Most people who have bypass surgery develop pleural effusions -- fluid in the space between the lungs and the inside of the chest cavity -- after the operation. Effusions that persist for six months are rare. Rarer still is Clinton's problem -- thickening of the pleura that prevents the lung from fully inflating.

The former president's wife, Sen. Hillary Rodham Clinton (D-N.Y.), and their daughter, Chelsea, were at the hospital during the operation and visited him immediately afterward.

The operation was done under general anesthesia. To help relieve pain when he awoke, the physicians also provided epidural anesthesia for the portion of his chest where the incision was made.

Clinton, who is 58, has a tube in his chest to drain fluid that may accumulate in the next few days. He is expected to be in the hospital as many as 10 days.

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