Mar 10, 2005 By Josh Krysak 4 min read

With former President Bill Clinton scheduled to undergo surgery to remove scar tissue and fluid from his recent heart bypass surgery today, one area expert said that with Clinton’s active lifestyle and fairly good health, the 42nd president should make a full recovery. “This is a pretty normal procedure,” General and Thoracic Surgeon Dr. Josef Vanek said Wednesday in his Uniontown office.

The heart specialist said he has performed dozens of the same operation over the years and that with advances in technology, the minimally invasive surgery can be wrapped up in about an hour.

“It is not uncommon to see some fluid in the chest after open-heart surgery,” Vanek said. “Sometimes the body reabsorbs the fluid, sometimes it needs to be removed.”

Clinton’s doctors at New York-Presbyterian Hospital/Columbia University Medical Center described the operation Tuesday, called decortication, as low-risk surgery, but Uniontown officials said anytime a patient is anestitized the surgery is serious.

“It is serious but with new technology, it is better than looking with the naked eye,” Anestiologist Janici Jevic said. “With this sophisticated equipment, we can avoid cutting through the ribs and muscle.”

And, hospital officials said, the same high tech tools used in Clinton’s surgery today, are available for surgeries performed at Uniontown, allowing area patients high-quality care without having to travel to hospitals out of the region.

Operating room team leader Renee Lazuka displayed the video monitor and wand that will be used in Clinton’s surgery as well as an array of grippers, graspers, cutters and trimmers, all attached to wands lined up on a medical tray like shotguns on a gun rack.

“We could have performed that surgery on Clinton right here,” hospital spokeswoman Karen Dei Cas said.

The Uniontown Hospital’s Cardiac Care Center does not perform heart bypass surgery like the one Clinton underwent last September, but the center routinely performs decortication as well as conducting thousands of cardiac diagnostic tests in the last year and hundreds of interventional catheterizations, in which a balloon is inserted into a clogged artery to help remove the blockage and create blood flow.

The hospital has had the diagnostic catheterization lab since 1997 and has been doing balloon angioplasties since 2003.

Clinton’s decortication surgery will remove scar tissue that is pressing down on Clinton’s left lung either through a small incision or with a video-assisted thorascope inserted between his ribs.

Vanek said the time frame for fluid buildup in Clinton is about right as well, with patients usually experiencing fluid discomfort in the first six months after surgery. Clinton was operated a little more than six months ago.

Clinton underwent quadruple coronary artery bypass surgery early in September after suffering chest pains and shortness of breath, which he blamed on a history of heart disease in his mother’s family and his penchant for junk food.

Vanek explained that if a quarter of his left chest and lung is filled with fluid, the buildup is quite substantial, with as much as a few liters of fluid possibly congesting the former president’s chest cavity.

Vanek said that while Clinton’s doctors are not releasing information about procedures conducted prior to the surgery, he suspects they will attempt to drain the president’s lung with a catheter, what Vanek described as “a first step” when fluid begins to backup.

The procedure itself involves a surgeon operating a mini 10-millimeter camera on a wand inserted through a small incision or a series of incisions between the ribs.

The scar tissue is then cut away with miniature grabbers and scalpels mounted on wands and operated like a tattoo gun. The cutting devices also cauterize the tiny incisions instantly, helping to minimize bleeding. Then, Lazuka said, a suction device is used to clear away the tissue and fluid as well as any blood from the surgery.

Lazuka said when the surgery is completed the patient will have a drain inserted in their chests to continue to remove any excess fluid.

“The key to the surgery is when they evaluate if the lung will re-expand,” Vanek said. “They will see if the lung is free enough to fill the space occupied by the fluid.”

Vanek said if the lung won’t expand, the doctors would have to attempt a more invasive procedure, most likely opening the chest cavity again and working to remove the fluid that way.

Vanek said with Clinton’s relatively young age (he is 58 years old) and fairly good health, he should be out of the hospital in three to fours days, with full recovery taking a few weeks.

“This is obviously not as major as open-heart surgery, but he is not going back to playing golf right away, either,” Vanek said.

And Vanek said there is always the possibility that the surgery will need to be performed again.