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After heart procedure, former president Bill Clinton released from hospital

By Philip Rucker and David Brown
Washington Post Staff Writer
Friday, February 12, 2010; 8:27 AM

Former president Bill Clinton was released Friday morning from a New York hospital, where he stayed overnight after doctors inserted two stents into a clogged coronary artery after he complained of chest pains. The one-hour procedure went smoothly, according to his cardiologist.

Clinton, 63, was released from New York Presbyterian Hospital's campus at Columbia University early Friday morning "in excellent health" and will soon return to his work on Haiti's relief and long-term recovery, his office said.

Clinton underwent the procedure at the same hospital where he underwent quadruple heart bypass surgery in 2004. The former president had recurring episodes of chest pain over the past several days, a Clinton aide said, and he could have suffered a heart attack if the condition had gone untreated.

Clinton's cardiologist, Alan Schwartz, said the former president would recover fully and resume his "very active lifestyle." Within two hours of the operation, Clinton was walking around his hospital room, and Schwartz said he could return Monday to his work leading the humanitarian response to the Haiti earthquake.

"This was not a result of either his lifestyle or his diet, which have been excellent," Schwartz told reporters from the hospital steps Thursday night. "This is part of the natural history. Just as illnesses have natural histories, treatments have natural histories."

Clinton's associates said he has been working at a grueling pace since the Jan. 12 earthquake in Haiti, but they said his demanding schedule did not contribute to his heart problems. Clinton, the United Nations special envoy to Haiti, is overseeing the U.S. response with former president George W. Bush. Clinton has twice shuttled between his New York home and Port-au-Prince in recent weeks.

Clinton was working on issues related to Haiti on Thursday morning when he felt chest pains, associates said. As he was being wheeled into the operating room, they said, Clinton was on a conference call about Haiti; aides had to take his cellphone.

"President Clinton is in good spirits, and will continue to focus on the work of his Foundation and Haiti's relief and long-term recovery efforts," Douglas Band, a longtime Clinton aide, said in a statement.

Clinton's daughter, Chelsea, joined him at the hospital, an aide said. Secretary of State Hillary Rodham Clinton, who is scheduled to leave Saturday for Qatar and Saudi Arabia, flew to New York late Thursday to join her family.

President Obama called Clinton about 7 p.m. Thursday and wished him "a speedy recovery," a White House aide said. Clinton told Obama he was feeling "absolutely great," the aide said, and Obama replied that "the efforts in Haiti were too important for him to be laid up for too long" and hoped he'll be "ready to get back to work as soon as possible."

David Sherzer, a spokesman for Bush, said the 43rd president called Chelsea Clinton on Thursday and "looks forward to continuing to work with his friend on Haiti relief and rebuilding."

Paul Farmer, deputy United Nations envoy to Haiti, said Clinton has been working "pretty nonstop" since the earthquake.

"He's been putting heart and soul into Haiti," Farmer said. "Everybody who's been working with him knows how hard he's been working on Haiti and how much he's been traveling and thinking about Haiti. . . . He's inspiring all of us."

Chest pain, known technically as angina pectoris, is the cardinal symptom of insufficient blood and oxygen getting to the heart muscle. The usual cause of the problem is a narrowing -- or, more ominously, a complete blockage -- in one of the three coronary arteries feeding the muscle.

Although few details of the former president's operation are known, in such cases a plastic catheter is generally inserted in an artery in an arm or a leg and snaked into the narrowed section. A balloon is then inflated to widen the narrowed section, and a stent -- a short section of wire-mesh tube -- is left to keep it propped open.

Over a period of months, the body coats the inside of the stent with a layer of cells similar to those that line blood vessels. Most patients take several blood-thinning drugs to prevent the formation of blood clots on the stent.

Jonathan S. Reiner, director of the cardiac catheterization laboratory at George Washington University Hospital and former vice president Richard B. Cheney's longtime heart doctor, said: "Typically, patients recover very quickly from a procedure like that."

In September 2004, Clinton, then 58, underwent emergency heart bypass surgery at Columbia Presbyterian. Doctors found four major blood vessels that supply oxygen to Clinton's heart were blocked, some by as much as 90 percent. Surgeons used two arteries running along the inside of his chest wall and a vein cut out of his leg to form conduits around four narrowed segments of his coronary vessels.

With a family history of heart disease, plus high cholesterol and high blood pressure, Clinton had three major risk factors for a heart attack. During his presidency, Clinton was known to smoke cigars and indulge in fast food, but he adjusted his lifestyle after the first operation.

Terry McAuliffe, a close family friend, said Clinton exercises daily at his home in Chappaqua, N.Y. -- preferring long walks, runs on a treadmill and weight-lifting sessions in his garage -- and eats a lot of grilled fish. "He's very careful about what he eats," McAuliffe said.

Taylor Branch, another longtime friend, said, "I've been concerned sometimes that he looked too skinny."

After the 2004 operation, Clinton told ABC News anchor Peter Jennings that "it changed me."

"If you dodge a bullet like I did . . . you have to ask yourself, 'Well, you got a little extra time here. What are you going to do with it?' " Clinton told Jennings.

Last year was one of Clinton's most physically demanding years, associates said, as he traveled the globe securing donations during the recession to keep afloat his foundation's charitable projects on global health, climate change and other issues.

"It was a lot of stress," said Branch, who recalled a recent conversation with Clinton. "I asked him how his heart was doing, and he said he thought it was as good as he could expect at his age."

Staff writers Glenn Kessler and Anne E. Kornblut and research editor Alice Crites contributed to this report.

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