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Saturday Morning News

David Letterman Expected to Make Full Recovery

Aired January 15, 2000 - 9:39 a.m. ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

MILES O'BRIEN, CNN ANCHOR: We begin with David Letterman. Talk show host David Letterman is expected to make a full recovery from an emergency quintuple bypass operation, this according to his doctors. Letterman had the surgery yesterday just hours after a routine test found a blocked artery. Letterman says he went in for the test because he has high cholesterol and a family history of heart disease.

Joining us from New York is our medical correspondent, Dr. Steve Salvatore, for a little more insight into the bypass procedure.

Steve, thanks for being with us this morning.

DR. STEVE SALVATORE, CNN MEDICAL CORRESPONDENT: Sure, good morning.

O'BRIEN: All right, first of all, just give us the basic outlines of how this surgery works. These -- I think the assumption a lot of people have is that it's fairly straightforward and simple. It's not as simple as it sounds, is it?

SALVATORE: Miles, it's not as simple as it sounds. What happens during this surgery is, doctors essentially have taken a picture already of, say, a heart, and they notice all these blockages. They then determine that they have to go around and bypass the blockages.

So what they'll do is, they'll take a vein or a artery, actually, from the chest, and they'll use that to connect part of the artery that's open and go around the blockage and connect it to the other part.

The idea, of course, is that the blood will flow directly, then, to where it's supposed to go, to the heart muscle so it doesn't fail.

But this is a very involved procedure. What it usually takes is cooling down the body, and eventually stopping the heart. The patient is then put on a heart-lung bypass machine. In other words, if your heart's not beating, the brain still has to go, the kidneys have to live. So this machine pumps the blood and oxygenates it and sends it to the rest of the body while they perform the surgery.

Then, when everything's completed and they feel that all the blockages have been bypassed, they'll then jumpstart and restart the heart back. And sometimes it kicks in right away, sometimes it doesn't, and it takes a little more work. But it is quite, quite a difficult and challenging procedure.

O'BRIEN: Well, maybe it's good he only had a few hours to think about it. It sounds, the way you describe it, you know, shutting your heart down is the you wouldn't want to take lightly.

How common is this surgery now? It's nothing less than -- excuse me -- revolutionary for many of the patients would perhaps take it for granted. How common has it become?

SALVATORE: Well, I can tell you that in 1995, over half a million people have had this procedure done. But what's happened recently in recent years with angioplasty -- that's that procedure where doctors put a catheter up into the arteries, into the heart, and inflate a balloon to open it, that's actually cut into some of the bypass surgery cases that have been done.

So the numbers have decreased recently, but still there are some blockages that aren't amenable to angioplasty and can't be fixed by angioplasty and still need to be done with bypass surgery.

So we have a feeling that bypass surgery won't totally go away and be replaced. But, you know, it -- the numbers are down, but still quite a large number of people have it done.

O'BRIEN: And as we know, the success rate on this very high.

Let me ask you this. Folks at home watching this, how would they know if they might be a candidate for this? What would be the warning signs or the indications that would lead one to go to a doctor and say, Hey, check me out for this?

SALVATORE: Well, usually people will complain of chest pain or tightness in the chest or maybe pain in the shoulder. And a lot of people don't know, also pain in the neck and jaw with exertion, or maybe even at rest. But the thing is, you don't jump right from that to bypass surgery. Usually your doctor, depending on what your symptoms might be, might do a simple thing at first like an EKG, then followed by a stress test.

And depending what they see on the stress test, they might do just like in David Letterman's case and say, You know what? Maybe we need to do an angiogram. That's where doctors basically inject dye into the blood vessels of the heart and look and see what the blockages are, if any.

There are also a whole slew of other cardiac tests that can be done to determine blood flow to the heart, and they can make an assessment there.

And then you have to remember also, for instance, in -- I hate to keep referring to David Letterman, but in his case, he has a family history of high cholesterol. This is something he's been concerned about. So you have to weigh those risk factors in also.

O'BRIEN: Dr. Steve Salvatore, one of our senior medical people here at CNN, joining us early on a Saturday morning. We appreciate you coming in and doing a little bit of extra duty.

SALVATORE: My pleasure.

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