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Yeltsin Admits He’s Ill, Will Have Heart Surgery

After 11 weeks of mysterious absences from the Kremlin, President Boris N. Yeltsin announced Thursday he soon will undergo heart surgery.

The 65-year-old president, looking pale and speaking slowly, broke the news in a televised interview, saying the procedure would be done near Moscow at the end of September.

The evening announcement partially lifted the veil of Kremlin secrecy about the severity of his illness, but it raised questions about his prospects for recovery.

“I had a medical checkup and they found a heart disease,” Yeltsin said. “The recommendation of our doctors was either an operation or more passive work. I have never been satisfied by passive work. … It is better for me to have an operation and fully recover, as they promise, than to engage in passive work.”

Yeltsin’s physical decline has set off an open struggle among his top aides for control of the nation.

Although Yeltsin did not specify the kind of operation, a spokesman for Moscow’s Cardiology Research Center, Vitaly I. Dmitriyev, said the president will undergo coronary bypass surgery there.

Heart surgery in Moscow probably is not much riskier than it is in the United States, assuming the patient carefully picks the surgeon and hospital, according to several American doctors who have had direct contact with Russian medicine and its practitioners.

The best-known American heart surgeon, Michael E. DeBakey of Baylor University in Waco, Tex., said Thursday that the risk of dying after heart surgery in Russia is “reasonably comparable” to that in major American hospitals.

Specifically, the risk that a coronary artery bypass patient will die in surgery or in the month afterward is less than 5 percent, DeBakey said, citing information he has gotten on numerous visits to Moscow. “Their operative mortality is within our range,” he added.

But other medical specialists warned that the operation is quite risky for Yeltsin and might require as long as three months’ convalescence.

The president was hospitalized twice last year, in July and October, for myocardial ischemia, a partial blockage of the coronary artery that restricts the flow of blood and oxygen to the heart. It is the most common heart ailment - and cause of death - in the United States and Russia.

Yeltsin recovered without surgery to wage a vigorous campaign for reelection but suddenly dropped from public view about two weeks before his July 3 victory. Since then, his only public appearances have been in brief, carefully edited television footage and at his Aug. 9 inauguration.

Yeltsin’s interview, conducted by RIA-Novosti Television and aired on all national channels, was the first time a Kremlin leader openly has discussed his health on the air in such detail.

“I want to have a society based on truth,” said Yeltsin, who was wearing a sweater and sitting in an armchair at a Kremlin hunting lodge in Rus, 60 miles northeast of Moscow. “That means no longer hiding what we used to hide.”

The president did not say whether he would hand presidential power during his surgery to Prime Minister Viktor S. Chernomyrdin. In the event of Yeltsin’s death, Chernomyrdin would, by law, become president but would have to call a presidential election within three months.

Having endured a divisive campaign in which Yeltsin fought back a strong Communist challenge, Russians have little desire for another election soon. But they already are watching ambitious men around Yeltsin, as well as the Communists, maneuver fiercely as if the president’s days are numbered.

Security chief Alexander Lebed, for example, has moved swiftly and boldly, without unconditional support from the absent president, to make peace with separatist rebels in Chechnya. Chernomyrdin and Yeltsin’s chief of staff, Anatoly B. Chubais, have damned Lebed with faint praise, while Moscow Mayor Yuri Luzhkov and Communist leader Gennady A. Zyuganov have accused him of surrendering the tiny southern republic.

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