Doctors to fix hole in Sharon's heart

Sharon's stroke caused by a congenital defect present in 15% of the population.

sharon 88 (photo credit: )
sharon 88
(photo credit: )
Prime Minister Ariel Sharon will in two weeks undergo a catheterization to insert a clam shell-shaped clamp on two sides of a small hole in his heart. The procedure will prevent the formation of more blood clots and greatly reduce his risk of a recurrent stroke. This was announced by Prof. Chaim Lotan, chief of cardiology at Jerusalem's Hadassah-University Hospital at Ein Kerem, and Prof. Tamir Ben-Hur, the hospital's chief of neurology, both of whom were responsible for the 77-year-old prime minister's treatment during his day-and-a-half hospitalization after a mild stroke last week. Lotan will head the team chosen to perform the procedure, which is usually carried out under partial or complete sedation. A press conference, more than an hour long, was held in a dark room of Jerusalem's Beit Agron press center to discuss Sharon's medical condition and treatment. Only diplomatic and political reporters were invited, rather than health reporters who are more likely to comprehend the terminology and ask wellness-related questions. In addition, no test data were distributed in writing, no visual material was provided and cameras and tape recorders were barred. In addition to Lotan and Ben-Hur, the medical team included Sharon's personal physician, long-time Sheba Hospital director-general Prof. Boleslav Goldman and Sheba internal medicine expert Prof. Shlomo Segev. The doctors revealed that when Sharon arrived at Hadassah on Sunday, he was not able to communicate. Ben-Hur said that at the time Sharon would have been incapable of running the nation due to his inability to speak. Doctors said that all of Sharon's other faculties were functioning and that his speech returned shortly thereafter. The prime minister's spokesman, Asi Shariv, was the only Sharon aide at the briefing. Shariv said that when the catheterization procedure takes place in two weeks there will be no need for an acting prime minister because Sharon will not be incapacitated. Sharon was put through computerized tomography and magnetic resonance imaging scans at Hadassah after his mild stroke, to determine the source of the small blood clot that became stuck in a vessel in his brain and caused ischemia (lack of oxygen), which reversed itself when the clot broke up. Ben-Hur, who presented himself at the press conference "as a doctor and not a politician," said that a "very small spot" remained in Sharon's brain, but that the brain tissue and his cognitive and motor functioning were not affected. Dr. Goldman noted that in the past few years, Sharon has suffered from the flu a number of times, and has had some chronic back pain caused by bullet wounds to the shoulder in 1948. The doctors also discussed tests that were done, and will be done, to ensure Sharon's health. The doctors explained the steps they took immediately following the prime minister's stroke. Prof. Ben-Hur announced that Sharon had suffered no lasting damage from his stroke, and that his health is now the same as it was prior to the incident. Angiography showed a hole called a foramen ovale, an opening in the wall between the right and left auricles of the heart. This naturally occurs during fetal development and provides a bypass for blood that would otherwise flow to the fetal lungs. But since the fetus cannot breathe oxygen, the foramen must be open. Normally the hole begins to close after the baby takes its first breath, causing full blood circulation to the lungs and not between the two auricles. But in about 15 percent of cases, it does not close fully. Most people never know of the hole because it causes no harm, but in some cases, it can result in the formation of blood clots that travel in the body and can cause a "brain attack" (stroke), as it did in Sharon. A trans-esophageal echo (ultrasound) will be performed along with the catheterization, in which a tiny catheter is pushed through a small incision, usually in the groin area, and into the heart. The clamp will be attached on both sides of the hole and opened like an umbrella to close the opening. Lotan said this procedure is carried out routinely in Israel, especially in children. The doctors said the obese Sharon currently weighs "115 kilograms, having lost three kilos during his 36 hours in the hospital," and, at 1.7 meters tall, should ideally weigh no more than 80 kilos. Other doctors who have observed Sharon said it was "impossible" for his weight to be "only" 115, and said he must weigh at least 140 kilos. The doctors said they were not optimistic that Sharon, at his age and with his appetite, would get down to his optimal weight. His cholesterol level was described as "high-normal." Sharon's previous medical history included acute bouts with influenza, bronchitis and hoarseness, as well as some chronic pain from being shot in his knee in 1948, and gout (which involves swollen toe joints, often due to eating too much meat and fat). He gets drugs for his chronic conditions (such as allopurinol for gout), and a synthetic thyroid hormone for a hypothyroid condition. Since the stroke, he has been getting a blood-thinning agent by injection at home. Goldman said Sharon would "sleep for half an hour during the catheterization procedure." When asked about having to run the country while unconscious Goldman, he said: "But he also sleeps at night, you know." Politicians accused Sharon of hiding his medical condition from the public, and the press of focusing on Sharon's health instead of on more serious issues. "The figures presented reveal how important it is for the public to know the prime minister's medical condition," Labor MK Ophir Paz-Pines said. "Better that he gave the information late than never. We hope that Sharon's diet won't be the only focus of this election." "Instead of the doctors revealing what is going on with Sharon's heart, Sharon should reveal his diplomatic plans," said Meretz leader Yossi Beilin. "Sharon has a responsibility to stop his approach of covering up and to tell the public the steps that he intends to take if they put the steering wheel of the country back in his hands." National Religious Party faction chairman Shaul Yahalom said that the press's focus on Sharon's health has caused the public to forget that Sharon's disengagement plan failed and that every day its destructive results and the rocket attacks are becoming more apparent. "The public must realize immediately that Sharon must be removed from the Israeli political stage."