Clinton on the Mend After Heart Surgery

NEW YORK —  Former President Clinton underwent successful quadruple coronary bypass surgery Monday and should be able to resume a full range of normal activities -- including some political campaigning -- within two months, his doctors said.

“He is recovering normally. He had a relatively routine operation, and everything looks straightforward,” said Dr. Craig Smith, the heart surgeon who led a 15-member medical team in the procedure at New York-Presbyterian Hospital.

Smith, who appeared at a news conference following the operation, said Clinton, 58, would spend the night in intensive care, transfer to a regular hospital room in the next several days and then go home for a recovery period of several months.

He said the former president should be able to live a full and active life.

Clinton’s wife, New York Sen. Hillary Rodham Clinton, issued a statement after the operation thanking “the incredible medical staff at the hospital for taking such good care of my husband.” She also thanked the more than 37,000 people who had sent e-mails and other messages since he checked into the hospital Friday.

“As many families know, open-heart surgery, though increasingly common, is a very serious procedure,” she said in a note written with her daughter, Chelsea, 24. “These past few days have been quite an emotional roller coaster for us.”

Although doctors said Clinton’s operation was routine, he was lucky to have been diagnosed with heart problems as quickly as he was, said Dr. Allan Schwartz, the hospital’s chief of cardiology, who was present for the operation.

Without prompt diagnosis and medical care, Schwartz said, “there is a likelihood he would have had a substantial heart attack in the near future.”

The physicians said Clinton, who otherwise was in good physical shape, had been complaining of chest pain and shortness of breath during workouts in recent months. He initially chalked it up to sporadic interruptions in his exercise regimen because of an extended national book tour, as well as recurring bouts of acid reflux.

But the former president sought medical help late last week when he experienced the symptoms for 15 to 20 minutes while at rest, Schwartz said.

Clinton went to a Westchester County hospital near his home in Chappaqua, N.Y., on Thursday evening, and an angiogram the next morning revealed significant blockage in the major blood vessels leading to his heart.

Clinton was transferred to New York-Presbyterian, an internationally renowned medical center, where doctors recommended immediate surgery, said Smith, the hospital’s chief of cardio-thoracic surgery.

But the surgical team waited until Monday morning to allow the blood-thinning medication that Clinton had been taking to work its way through his system in order to prevent major bleeding during the operation.

The procedure began at 8 a.m., with doctors surgically sawing open Clinton’s chest. They used segments of arteries from his chest wall as well as a segment of vein snipped from his leg to reroute the blood flow around his blocked heart arteries, Smith said.

During the surgery, Clinton’s heart was stopped, and he was hooked up to a heart-and-lung machine. His heart resumed pumping after the new blood flow was created, Smith said, and the team of doctors left the operating room at about noon.

More than 500,000 such operations are performed every year in the United States, according to the Centers for Disease Control and Prevention. The procedures can dramatically reduce the number of deaths from heart disease, the nation’s No. 1 killer, but the key to success is early diagnosis and treatment, physicians say.

Clinton’s health will depend heavily on a low-salt, low-saturated-fat diet, as well as exercise and medications, Smith said. Doctors declined to put a strict timetable on his recovery because each person has individual needs and, as Smith noted with understatement, “this is not the average person in recovery.”

The former president spent hours with his wife and daughter leading up to the surgery; they played games, watched television and had long conversations. He tried to stay active, taking calls from close friends and political well-wishers.

On Saturday, friends said, he gave advice about the presidential race to Democratic candidate Sen. John F. Kerry.

“He spoke a long time with Kerry,” said James Carville, a Clinton confidant, who also spoke to his former boss.

“I’d say he and I were talking about politics much more than we were about the upcoming heart surgery,” Carville said on CNN’s “Crossfire.” “He was very animated in the last day or so, and he really wants to get out and work for Kerry.”

Clinton, however, must wait for a green light from his doctors before hitting the campaign trail. Though he has appeared more fit in recent months because of regular workouts with a trainer and a more healthy diet, the former president loves junk food and fought a lengthy battle to lose weight. Friends caution that old habits die hard.

Clinton will have to permanently change his lifestyle in at least one key respect, Carville said, adding: “I’d suspect now that if he tries to order a burger and French fries on the road, someone will undoubtedly rat him out to Hillary and Chelsea.”