ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Monday, September 23, 1996 TAG: 9609230092
SECTION: NATIONAL/INTERNATIONAL PAGE: A1 EDITION: METRO
DATELINE: MOSCOW
SOURCE: ASSOCIATED PRESS
note: above
PAVEL VOSHCHANOV told the media that Russia's president suffers from liver, kidney and a myriad of other health problems.
Boris Yeltsin is pushing for his bypass surgery to be performed soon, but his chief surgeon said Sunday the procedure is too risky to rush and could be canceled.
Yeltsin had said the surgery would take place at the end of September. However, Dr. Rinat Akchurin said it may not be performed until mid- to late November, depending on results of heart tests to be done this week.
Asked whether the surgery might be canceled, Akchurin told the Russian NTV network's ``Itogi'' show, ``It's possible, but we would have to create [lifestyle changes] for the patient which he himself would not tolerate.''
The intrigue surrounding Yeltsin's condition was ratcheted up Saturday by Pavel Voshchanov, a journalist and former Yeltsin top aide who told Associated Press Television that the 65-year-old president has problems with his back, with his hearing and with blood vessels in his brain.
Voshchanov, Yeltsin's press secretary from July 1991 until he resigned in February 1992, also said the president has liver and kidney trouble that has been exacerbated by his drinking, contradicting statements from one of Yeltsin's physicians.
His disclosures followed Akchurin's suggestion that aides covered up a Yeltsin heart attack in the closing days of the summer presidential campaign.
Voshchanov said Yeltsin has ``a problem with blood vessels in the brain, which causes one to suspect the development of atherosclerosis,'' fatty deposits that clog the arteries and can lead to a stroke.
``And his spine is ill as well,'' Voshchanov said. ``He has very strong headaches, and he has inflammation of the middle ear and can barely hear out of that ear.''
Voshchanov claimed Yeltsin also has problems with his liver and kidneys, ``one of which almost refuses to function.'' He did not elaborate, but related the problems to Yeltsin's drinking, which he said complicated scheduling decisions.
``Sometimes I couldn't answer questions about our upcoming plans because so much depended upon whom we would have dinner with, how we would have dinner, and upon what and how many [bottles] would be standing on the tables,'' he said.
Dr. Sergei Mironov, the Kremlin's chief physician, denied last week that Yeltsin has major liver or kidney problems, but acknowledged other problems he said may complicate surgery. He did not identify them.
Yeltsin has been hospitalized since Sept. 13 for what aides said then would be a couple of days of pre-surgery tests. Akchurin said doctors are trying to improve Yeltsin's general heart condition.
The Kremlin has said nothing about Yeltsin's bouts of unusual behavior and hospital stays in recent years. His disappearance before the second round of presidential voting July 3 was explained variously as exhaustion and a cold.
But Akchurin told ABC News on Friday that Yeltsin had a heart attack this summer. Akchurin said Sunday that it actually was an attack of stenocardia that did not damage the heart.
Stenocardia is known as unstable angina in the United States. It is unusually intense or prolonged chest pain, sometimes occurring even when people are resting, that results from reduced blood flow to the heart.
The attack occurred, Akchurin said, while Yeltsin was campaigning in the Ural Mountains in June, but did not slow Yeltsin down.
``It was caused by everything - his cold, his travels and his merciless treatment of himself as a human being,'' Akchurin said.
Heart experts have said Yeltsin's surgery likely would be a triple bypass, but there has been no official word on its nature.
Yeltsin's daughter, Tatyana Dyachenko, told Russian Television on Sunday that the family convinced him to stay in the hospital to prepare for surgery.
``He feels well, or at least as normal as one can feel before a surgery,'' she said. ``Naturally, he has some anxiety.''
Yeltsin is spending time with his wife, who is recuperating from kidney surgery at the same hospital, and is working, Dyachenko said.
A team of doctors, including American cardiologist Michael DeBakey, is expected to make final decisions about the surgery after a Wednesday meeting and examination of Yeltsin.
Akchurin said Yeltsin will undergo echocardiography, an ultrasound test of the heart that determines how well it is functioning, and a radioisotopic myocardium exam, which shows whether damaged areas of the heart are still alive and, therefore, whether they can be surgically restored.
DeBakey left Houston on Sunday for Russia. He told reporters he knew little about Yeltsin's condition.
``I have formally been approached and invited to be a consultant,'' he said. ``What that involves, I have to wait until I get there and see.''
Doctors also may be dealing with liver disease, which thins the blood and complicates surgery, said Dr. Samin Sharma, director of interventional cardiology at The Mount Sinai Medical Center in New York.
``What they're probably trying to do by putting him in the hospital now is trying to resolve all these problems,'' Sharma said.
In the United States, he said, surgeons would perform a liver transplant and heart bypass at the same time on such a patient, but Sharma said he suspects Russian medical technology doesn't allow for that.
Akchurin trained for six months with DeBakey in Houston in the 1980s and did a bypass on Prime Minister Viktor Chernomyrdin in 1988.
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