Yeltsin Heart Operation Called a Success

By David Hoffman
Washington Post Foreign Service
Wednesday, November 6, 1996

MOSCOW, NOV. 5 -- President Boris Yeltsin underwent a seven-hour operation today to circumvent five clogged arteries supplying blood to his heart. Surgeons and Kremlin officials announced that the operation had been a success and that Yeltsin regained consciousness tonight.

{Yeltsin reclaimed his presidential powers Wednesday morning by signing a decree, his spokesman, Sergei Yastrzhembsky, told the Reuter news agency. "The president is regaining his strength quite quickly," Yastrzhembsky said.}

Yeltsin earlier had transferred his formal powers to Prime Minister Viktor Chernomyrdin, including the black attache case carrying codes to activate nuclear weapons. Chernomyrdin and Yeltsin's wife and daughters remained at the hospital during the surgery.

Yeltsin, 65, was reported to be in stable condition. He remained connected to a mechanical ventilator in intensive care, and physicians said he faced a difficult postoperative period.

Naina Yeltsin said in a brief television appearance that she had not been able to see her husband but was assured by his doctors that the operation was successful. "We're very worried, of course, very worried," she said, apparently holding back tears.

Renat Akchurin, the surgeon who led the medical team for the operation at the Moscow Cardiological Center, told reporters the surgery was without complications. Yeltsin's heart is "getting enough blood to function normally," he said.

The surgeons created a new system of blood supply to much of Yeltsin's heart. The existing network of vessels was inadequate because many sections were narrowed or entirely blocked by fat deposits, limiting the supply of blood and oxygen to the constantly beating heart. Such a problem can cause chest pain, damage to the organ's pumping capacity and death.

In Yeltsin's case, two blood vessels were used to create the new network in a procedure known as coronary artery bypass grafting.

One vessel was the left internal mammary artery, which runs alongside the breastbone and gives off branches to the ribs and breast on the left side of the chest. It was cut partway along its course and attached -- or grafted -- to one of the president's coronary arteries downstream from the narrowed area. The tissues that normally would be served by the internal mammary artery are not hurt by this procedure because they are served by other arteries as well.

The second vessel was the saphenous vein, which runs up the inside of the leg. It was tied off, cut and transferred to the chest, where pieces of it were used to detour blood around narrowed vessels.

Although it is technically difficult to graft with the internal mammary artery, the effort is worth it. Whereas only 40 to 60 percent of saphenous vein grafts are still open 10 years after surgery, more than 90 percent of internal mammary artery grafts are. On average, people who have had internal mammary grafts also live longer.

Asked whether Yeltsin had required a triple or quadruple bypass, Akchurin replied, "The number of bypasses significantly exceeds the number you mentioned. And the operation went normally."

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