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Yeltsin had heart attack during Russian elections

Doctor says surgery may be too dangerous


September 21, 1996
Web posted at: 12:00 p.m. EDT (1600 GMT)

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MOSCOW (CNN) -- President Boris Yeltsin suffered a heart attack in late June or early July, shortly before the second round of the Russian elections, according to the doctor who is to perform heart surgery on the Russian president.

Dr. Renat Akchurin, the lead surgeon for Yeltsin's upcoming heart bypass surgery, said Saturday that the procedure may be postponed because of the risks to his life.

"We can postpone the operation, but ... we are trying to go ahead with it," the doctor said.

Akchurin said he had not been involved in the treatment of Yeltsin's health problems this summer, but based his diagnosis on fresh scarring seen on Yeltsin's heart in recent electrocardiograms.

In an interview with ABC News televised Friday, Akchurin said Yeltsin had withheld the information about the heart attack for political reasons.


"Can you imagine what would happen, for example, if he told everyone he's had a heart attack and he's unable to work?" Akchurin said.

Yeltsin virtually disappeared between the two election rounds, causing observers to speculate that he was seriously ill and prompting talk of a leadership vacuum at the Kremlin. The Kremlin has explained his absences by saying he was simply tired or was suffering from a cold.

Yeltsin's doctors Friday gave the frankest admission yet of the president's health prospects.

Dr. Sergei Mironov, the Kremlin's chief physician, said Yeltsin would stay in the hospital another three or four days -- extending for the third time a pre-surgery stay that originally was to last two days and end last weekend.

"We must understand that the person is preparing for a very responsible and a very serious operation," Mironov told a televised news briefing. He said the prolonged hospitalization was meant to ensure that problems with other organs don't complicate the surgery.

"A big and serious operation is ahead and it needs adequately large, balanced and serious preparations, because you all understand what is at stake."

Yeltsin announced September 5 that he would have heart surgery at the end of the month; no date has been announced.

Other problems

Mironov admitted that Yeltsin has other health problems besides his heart, but didn't provide details.

Addressing rumors of liver problems, the physician said that organ is always a consideration with a patient of Yeltsin's age. He is 65. But Mironov added there are "no big problems." He added that Yeltsin's kidneys are "functioning absolutely normally."

Yeltsin suffers from restricted blood flow to the heart. And Kremlin sources have told CNN that two of Yeltsin's coronary arteries, which carry oxygenated blood to the heart, have blockages.

Often in cases of blocked heart arteries, balloon angioplasty is performed. This means doctors insert a balloon catheter into a femoral artery and guide it to the blood vessel or heart valve to be treated. The balloon inflated and deflated several times to widen the narrow section before it is withdrawn.

Political backup

Communist leader Gennady Zyuganov, who lost the election to Yeltsin, has been a vocal critic of Yeltsin's ability to perform his duties while in poor health. He has called for a law requiring that the president's health be checked.

Under Russia's constitution, the prime minister would take over if the president died or was incapacitated, and new elections would be held within three months.

Yeltsin victory

Yeltsin will hand over power to Prime Minister Viktor Chernomyrdin while under anesthetic during the operation. That entails temporary control over the button that could launch a nuclear strike.

The nuclear button is not only a significant military weapon, it is "a symbol of state power," political analyst Alexei Arbatov said.

Complex process

Pulling the nuclear trigger would involve several stages. The president -- or in this case his prime minister -- would receive coded information that Russia was under attack. He would then decide whether or not to launch a nuclear counter-attack and send those encoded orders by computer to a designated command post.


There, a high-ranking military officer has to send on those order with his own encoded message as part of an elaborate system of safeguards.

To eliminate confusion, Yeltsin signed a decree outlining exactly how his power over this nuclear system will be passed to his prime minister and how it will be returned to him following surgery.

But further decrees will be needed -- one to hand over power and another to take it back when Yeltsin recovers from the anesthetic. Decrees will also be issued to determine the minute when Yeltsin hands over power during the operation.

The Interfax news agency said it was possible that Yeltsin would hand over power for only a few hours.

A doctor's council will meet September 25 to decide the date and details of Yeltsin's operation.

CNN Correspondent Eileen O'Connor and The Associated Press contributed to this report.


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