Sharon to have surgery

Procedure will mend tiny hole in prime minister's heart


JERUSALEM -- Prime Minister Ariel Sharon will soon undergo a medical procedure meant to mend a tiny hole in his heart which may have contributed to his minor stroke this month, his doctors announced yesterday.

The doctors described the planned catheterization procedure as the most common method of treating such a heart condition, which they said was a birth defect of a type that occurs in up to 25 percent of the population.

No date was set for the procedure, but doctors said it would take place within the next three weeks.

The health of the prime minister, who will turn 78 in February, has been under intense scrutiny in Israel since he was hospitalized Dec. 18 after what doctors described as a small stroke that caused no lasting neurological damage. He was released after two days, and aides say he has resumed his normal work schedule.

Sharon is the head of a new centrist political party that is widely expected to win general elections scheduled for March 28. But the party, called Kadima, or Forward, is built largely around Sharon's immense personal popularity among the Israeli electorate, and polls have suggested it might falter if anyone else were at the helm.

If Sharon were to be incapacitated during the medical procedure or for any other reason, his duties would be taken over by Deputy Prime Minister Ehud Olmert, who followed the Israeli leader to Kadima after Sharon abandoned his conservative Likud Party.

Commentators have expressed doubts that Olmert, an important behind-the-scenes confidant of Sharon, but one whose political persona is somewhat colorless, could muster a following like that of the prime minister.

Explaining the nonsurgical procedure to be carried out on Sharon, Dr. Haim Lotem, the chief of cardiology at Hadassah Hospital in Jerusalem, told journalists that doctors would use a camera-guided catheter to guide a small "umbrella-like" device into place to seal the hole in the upper chambers of the prime minister's heart.

Mild sedation is generally used to relax the patient's muscles when the catheter is inserted through the esophagus, Lotem said, but general anesthetic is not required. The procedure usually takes about 30 minutes.

In the meantime, Sharon is being treated with a blood-thinning medication to preclude the formation of blood clots, the doctors said.

The hole in Sharon's heart, measuring less than an eighth of an inch, was detected during tests conducted after the stroke. Doctors said yesterday that the small tear might have allowed a blood clot to pass through, which then triggered the stroke when it reached his cranium.

The prime minister's aides are portraying him as energetic and upbeat in the wake of his health scare. At a Cabinet meeting Sunday, the first he had presided over since being released from the hospital, Sharon joked with the ministers that they, unlike him, could go ahead and indulge - in moderation - in traditional calorie-packed foods such as jelly doughnuts and potato pancakes for the Hanukkah holiday, which began at sundown Sunday.

The overweight Sharon was put on a strict diet after the stroke, and doctors said he has lost about five pounds. They said the prime minister, who stands about 5 feet 7 inches tall, now weighs 255 pounds, though Israeli media reports have said he appears considerably heavier.

Despite his girth, Sharon's blood pressure and cholesterol levels are normal, the medical team said.

Doctors also disclosed additional details about Sharon's condition in the immediate aftermath of the stroke. Dr. Tamir Ben-Hur, the head of neurology at Hadassah, said the prime minister had difficulty speaking and his decision-making ability was temporarily impaired, but that he had complete recall of the evening's events.

Laura King writes for the Los Angeles Times.

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