In 60 to 70 percent of patients with blockage, less invasive treatments such as angioplasty, in which a clogged artery is opened by inserting a balloon, are indicated, according to Valentin Fuster, director of the cardiovascular institute at Mount Sinai School of Medicine in New York.
Clinton's office supplied few details about his medical care.
Media representatives gather at New York-Presbyterian Hospital in Manhattan, where Clinton is to have surgery.
(Gregory Bull -- AP)
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Video: Sen. Hillary Rodham Clinton, speaking at the New York State Fair, confirmed that the former president will need surgery.
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Transcript: Irving Kron, M.D., cardiovascular surgeon and chair of the Department of Surgery at University of Virginia Health Systems, discusses bypass surgery.
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Heart experts not involved in his treatment said he would be an excellent candidate for either of the two widely used types of heart bypass surgeries. Because he is a relatively young patient, the risks of complications are low, and patients typically recover in about a month. Both techniques have now become so routine that one surgeon described the operations as "fancy plumbing."
"If your water supply is blocked between the water main and your kitchen tap, when you open your faucet you may get a reduced water flow," said Jeremy Ruskin, director of the cardiac arrhythmia service at Massachusetts General Hospital. "One way to deal with that is to bypass the blockage -- you put a pipe near the main and run it into the point where the old pipe is blocked."
The surgery shunts blood around blocked arteries that feed the heart muscle with blood and oxygen. In the traditional technique, surgeons stop the heart from beating and pump blood through the body with a heart-lung machine. The new technique is called beating-heart surgery -- in which arterial bypasses are constructed even as the heart continues to beat.
The benefits of beating-heart surgery appear to be most pronounced in older patients because it has a lower risk of stroke and fewer cognitive problems associated with it. Subtler benefits may exist among patients in Clinton's age group as well, said Paul Corso, chief of cardiac surgery at Washington Hospital Center, but the issue was still being studied.
Heart bypass surgeries are performed when one or more of the arteries feeding the heart are blocked or choked off by buildups of fatty plaque -- high cholesterol levels are the leading culprit. The chest pains that brought Clinton into the hospital appear to have developed abruptly, but the root causes of the problem are likely to be several years old: During his last physical before he left the White House, Clinton had a total cholesterol count of 233 and a "bad" cholesterol count of 177.
Corso said that figure could indicate danger for someone of Clinton's age and body profile. Doctors now recommend that patients aim for a total cholesterol of under 180 and bad cholesterol lower than 70.
Last night, Clinton acknowledged he needed "to keep my cholesterol down, keep my blood pressure down."
For someone in fairly good health who is not diabetic, the risk of death as a result of open-heart surgery is 1 to 2 percent, said Ramin Oskoui, a cardiologist at Washington Hospital Center.
Jim Kennedy, a spokesman for the former president, said Clinton took calls offering best wishes from President Bush and former president Gerald R. Ford.
Campaigning yesterday in West Allis, Wis., the president told supporters that Clinton "is in our thoughts and prayers" and that he wished the former president a "swift and speedy recovery."
Kerry, campaigning in Newark, Ohio, told a rally: "I want you to let a cheer out that he can hear all the way to New York."
Clinton invoked politics when discussing his health last night on television: "Let me just say this, Republicans are not the only people who want four more years here."
