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Cheney Undergoes Angioplasty VP Hospitalized For Common Complications

By Susan Okie
THE WASHINGTON POST -- WASHINGTON

Vice President Dick Cheney’s recent episodes of chest pain were caused by a complication that occurs fairly frequently among patients who have undergone the kind of treatment Cheney received in November to restore blood flow to his heart, experts said Monday.

Cheney developed a renarrowing of the small artery in his heart that doctors opened last November, a complication that occurs in about one out of five patients who have a stent -- a hollow, spring-like device -- implanted inside a narrowed heart artery.

Doctors at George Washington University Hospital inflated a small balloon inside the affected artery Monday to open the area that had narrowed at one end of Cheney’s stent. Whether the problem will occur again, causing additional bouts of chest pain, is impossible to say, but Cheney’s cardiologist, Jonathan Reiner, estimated the chance of a recurrence at around 40 percent.

Even if the affected vessel were to close off completely, it is so small that it would be unlikely to cause a major heart attack, said Eric Topol, chairman of cardiology at the Cleveland Clinic, who is familiar with Cheney’s case. He said it probably is also too small for doctors to subject Cheney to the risk of a second bypass operation to fix it.

Cheney, who has had four heart attacks, underwent quadruple bypass surgery in 1988. His doctors evaluated the bypass grafts after his latest heart attack last fall and said they were all open and functioning.

Cheney’s doctors said in a briefing Monday night that the vice president has adhered faithfully to his diet, exercise and medical regimen. The renarrowing of the artery at the opening of the stent was caused by rapid scarring that can occur when a foreign body is placed in a blood vessel. It is different from the narrowing caused by the deposits of cholesterol that accumulate gradually in the arteries of people with heart disease.

“There aren’t any things that we know today that reduce renarrowing, in terms of diet, medicine or lifestyle,” said Topol. “It kind of has a mind of its own.”

Reiner said Cheney experienced four brief episodes of chest discomfort, including two on Monday that lasted three to five minutes each.