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Yeltsin Decides to Undergo Heart Surgery After Absence

By Richard Boudreaux
Los Angeles Times
MOSCOW

After 11 weeks of mysterious absences from the Kremlin, President Boris N. Yeltsin announced Thursday he will soon undergo heart surgery - a risky operation that could leave Russia without an effective leader at least until winter.

The 65-year-old president, looking pale and speaking slowly, broke the news in a televised interview, saying the procedure would be done near Moscow at the end of September. The evening announcement partially lifted the veil of Kremlin secrecy about the severity of his illness, but it raised questions about his prospects for recovery.

"I had a medical checkup and they found a heart disease," Yeltsin said. "The recommendation of our doctors was either an operation or more passive work. I have never been satisfied by passive work. It is better for me to have an operation and fully recover, as they promise, than to engage in passive work."

His physical decline has set off an open struggle among his top aides for control of a nuclear-armed nation with an imperialist history and an uncertain commitment to democratic rules. The infighting has already complicated efforts to settle Russia's 20-month-old war in breakaway Chechnya and is expected to intensify until - and unless - Yeltsin regains his vigor.

Although Yeltsin did not specify the kind of operation, a spokesman for Moscow's Cardiology Research Center, Vitaly I. Dmitriyev, said the president will undergo coronary bypass surgery there.

The president was hospitalized twice last year, in July and October, for myocardial ischemia, a partial blockage of the coronary artery that restricts the flow of blood and oxygen to the heart. It is the most common heart ailment - and cause of death - in the United States and Russia.

Yeltsin recovered without surgery to wage a vigorous campaign for re-election but suddenly dropped from public view about two weeks before his victory July 3. Since then his only public appearances have been in brief, carefully edited television footage and a slurring, stiff-legged performance at his Aug. 9 inauguration.

Bypass surgery is a routine procedure in the United States, where it is performed about 500,000 times a year, compared to about 20,000 in Russia. It involves diverting blood around a clogged portion of the patient's coronary artery by grafting onto it a piece of artery or vein removed from elsewhere in his body.

Other medical specialists warned that the operation is quite risky for Yeltsin and might require as long as three months' convalescence.

While most U.S. patients live 10 years or longer after bypass operations with no recurrence of the disease, such surgery in Russia is less advanced and relies on techniques abandoned in the West, according to specialists in both countries.

The Kremlin never disclosed the seriousness of Yeltsin's two illnesses last year or his recent relapse. If Yeltsin has suffered a stroke or a severe heart attack, bypass surgery would do nothing by itself to repair the damage.

"Given the lower quality of this procedure in Russia, given Yeltsin's hard lifestyle and given that he may have had some damage to his heart, his prognosis is not very good," said Dr. Manuel Cerqueira, associate chief of cardiology at Georgetown University Medical Center in Washington. "He should make it through surgery, but I think he's going to be limited in the future."

The death rate during bypass operations in Russia is similar to that in the West, doctors here say, but the danger for Yeltsin is probably far greater. A man with a long history of illness, punctuated by bouts of public drunkenness, Yeltsin has already lived seven years longer than the life expectancy for Russian males.

Yeltsin's interview, conducted by RIA-Novosti Television and aired on all national channels, was the first time a Kremlin leader openly had discussed his health on the air in such detail.

"I want to have a society based on truth," said Yeltsin, who was at a Kremlin hunting lodge in Rus, 60 miles northeast of Moscow. His face was pale and puffy, and he gestured listlessly with both hands. "That means no longer hiding what we used to hide."

The president did not say whether he would hand presidential power during his surgery to Prime Minister Viktor S. Chernomyrdin. In the event of Yeltsin's death, Chernomyrdin would by law become president but would have to call a presidential election within three months.

Copyright 19,95, The Tech. All rights reserved.
This story was published on 9/6/96.
Volume 116, Number 39.
This story appeared on page 2.

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