Former President Bill Clinton was resting in a New York hospital Thursday night after undergoing a procedure to increase diminished blood flow to his heart. Clinton, 63, had suffered chest pains earlier in the day, an adviser said.
Doctors at New York-Presbyterian Hospital placed two stents in one of Clinton's coronary arteries, half a decade after he underwent quadruple bypass surgery to open four blocked arteries.
Clinton, 63, was in "good spirits" after undergoing the procedure, adviser Douglas Band said.
Cardiologist Allan Schwartz said the former president had been feeling repeated discomfort in his chest, and tests showed that one of the bypasses from the surgery was completely blocked.
There was no sign Clinton had suffered a heart attack, and the new blockage was not a result of his diet, Schwartz said.
The doctor said Clinton could return to work Monday.
"The procedure went very smoothly," Schwartz said, describing Clinton's prognosis as excellent.
Terry McAuliffe, former Democratic National Committee chairman and a close friend of the Clintons, said Clinton participated in a conference call on earthquake relief as he was being wheeled into surgery.
He expected Clinton to be released from the hospital Friday.
McAuliffe said Clinton went to see his cardiologist after experiencing chest pains and shortness of breath. After that, his Secret Service motorcade took him to the hospital, where he walked in on his own.
Clinton's wife, Secretary of State Hillary Clinton, met with President Obama as scheduled Thursday, then headed to New York City.
Aides to Mrs. Clinton said she still plans to go ahead with a previously scheduled trip to the Persian Gulf. The trip was to begin Friday afternoon but could be delayed a day.
An Increasingly Common Procedure
Thursday's procedure was not as involved as the 2004 surgery, NPR health editor Joe Neel said on All Things Considered.
"He had some discomfort, he was feeling tired and he went to a cardiologist," Neel said, describing the events that led to Clinton's hospital trip.
At the hospital, in a process called angioplasty, a long, thin tube called a catheter is fed through an incision in the groin all the way to the heart.
"In this procedure, there would be a balloon on the end of [the catheter]," Neel said. "They would take X-rays while they're doing this, inject dyes and determine whether ... [Clinton's] arteries were actually closing down, whether there was any significant damage to the heart and muscle.
"Since we're hearing that he had two stents put in one artery, there must have been some significant weakening in those arteries," Neel said.
Angioplasty has become one of the most common medical procedures done worldwide. More than half a million stents are placed each year in the United States.
The Prognosis
Clinton's health problems are not to be minimized, but there's no reason to believe he can't resume his active public life.
"It's not all that uncommon for people to undergo multiple surgical procedures on their heart and live a long time," Neel noted.
In Clinton's case, a few months after the four-hour bypass surgery he underwent in 2004, doctors found scar tissue on his left lung.
"That's not unusual either, because during the heart bypass procedure, you're ... put on a heart-lung machine, and fluid can build up," Neel said. "So they took out the scar tissue, and as far as we know he recovered, and has been doing fine since then."
"It's not unexpected" for Clinton to need another procedure now, said Dr. Clyde Yancy, cardiologist at Baylor University Medical Center in Dallas and president of the American Heart Association.
The sections of arteries and veins used to create detours around the original blockages tend to develop clogs five to 10 years after a bypass, he explained. New blockages also can develop in new areas.
"This kind of disease is progressive. It's not a one-time event, so it really points out the need for constant surveillance" and treating risk factors such as high cholesterol and high blood pressure, Yancy said.
Overcoming Bad Eating Habits
Clinton entered the White House with a reputation for eating habits that left a trail of fast-food wrappers in his wake. Two of his favorite Arkansas restaurants were known for their huge hamburgers and thick steaks.
Early in office, he dropped in at a Washington, D.C., McDonald's for a bite during a morning jog.
"He's made note of his efforts to cut down on fatty food and exercise more," NPR's Joanne Silberner noted. "But arteries tend to reclog, and that's evidently what happened here."
The clog is caused as fat collects within the wall of the artery, pushing the wall into the space where blood should be flowing. A stent pushes the inner wall back into place and supports it there.
Hard Work On Haiti
Clinton, who served as president from 1993-2001, has been working in recent weeks to help relief efforts in Haiti. Since leaving office, he has maintained a busy schedule working on humanitarian projects through his foundation.
Clinton "will continue to focus on the work of his foundation and Haiti's relief and long-term recovery efforts," Band said.
Former President George W. Bush, who has recently worked with Clinton on relief efforts for Haiti, called Clinton's daughter, Chelsea, to tell her that "he looks forward to continuing to work with his friend," according to a statement released by a Bush spokesman.
President Obama called the hospital Thursday night to wish Clinton a speedy recovery, the White House said.
From NPR staff reports and The Associated Press
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