Former President Clinton to undergo surgery

Former President Clinton, who underwent quadruple bypass surgery in September, will undergo a medical procedure this week to remove fluid and scar tissue from his left chest, his office announced Tuesday.

The low-risk procedure will take place Thursday at New York-Presbyterian Hospital/Columbia University Medical Center.

Clinton is expected to make a "full functional recovery" and will remain hospitalized for three to 10 days, doctors said.

Clinton was proceeding with his schedule in Washington on Tuesday. He smiled and waved to reporters as he entered the State Department for meetings, but did not make any comment. He planned to be at a White House event later in the day, according to his spokesman, Jim Kennedy.

The procedure, known as a decortication, will remove scar tissue that has developed as a result of fluid buildup and inflammation, causing compression and collapse of the lower lobe of the left lung, his office said. The surgery will be done either through a small incision or with a video-assisted thoracoscope inserted between ribs.

Clinton's problem is a relatively rare complication of his surgery, where inflammation of the lining of the heart develops and fluid builds around it or in the lungs, said Dr. John LaRosa, president of the State University of New York Health Science Center in Brooklyn. It doesn't signal anything ominous about the former president's outlook, he said.

"It is unusual" for it to develop so long after the operation, said Dr. Valentin Furster, a cardiologist at Mount Sinai Medical Center in New York and a former American Heart Association president.

Clinton's office said: "The fluid buildup and lung collapse has caused the president some discomfort in recent weeks, but he has otherwise been in very good condition, recently passed a stress test and is walking up to four miles a day." The statement said Clinton is expected to resume his work without limitations.

Dr. Allan Schwartz, chief of cardiology at the hospital, said Clinton had recently passed a full physical before leaving on a trip to Asia last month to survey tsunami damage. He also scored in the 95th percentile for his age in a stress test, Schwartz said.

Clinton, 58, had been quite active since his Sept. 6 heart surgery in New York, presiding over the opening of his presidential library in Little Rock, Ark., and, more recently, joining the first President Bush for a public relations campaign to help raise private funds for the victims of the Asian tsunami.

Clinton underwent quadruple coronary artery bypass surgery last fall after suffering chest pains and shortness of breath.

In bypass surgery, doctors remove one or more blood vessels from elsewhere in the body and attach them to arteries serving the heart, detouring blood around blockages. The vessel typically comes from elsewhere in the chest, although doctors sometimes take one from an arm, a leg or the stomach.

Clinton previously blamed his blockage in part on genetics - there is a history of heart disease in his mother's family - but also said he "may have done some damage in those years when I was too careless about what I ate."

As president, Clinton was an avid jogger also known for his love of fast food. He has appeared much slimmer since early in the year, when he said he had cut out junk food, gone on the South Beach diet - which limits carbohydrates and fats - and started a workout regimen.

Clinton had a cancerous growth removed from his back shortly after leaving office. In 1996, he had a precancerous lesion removed from his nose and a year before that had a benign cyst taken off his chest.

But otherwise, Clinton suffered only the usual problems that often accompany normal aging and a taste for junk food - periods of slightly elevated cholesterol and hearing loss. In 1997, he was fitted with hearing aids. He also has had allergy problems.