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Cheney's bypass surgery a success

WASHINGTON — Vice President Dick Cheney was awake and alert after successfully undergoing surgery to treat swelling in blood vessels behind both knees, the White House said Saturday.

Cheney, who has a history of heart attacks, was recovering well after the six-hour surgery under local anesthesia at George Washington University Hospital, according to a White House statement.

The White House said the vice president would stay at the hospital as long as 48 hours and was expected to resume his schedule when he returned home. White House officials plan to brief Cheney on Hurricane Rita recovery efforts Saturday afternoon.

"The vice president is awake, alert, and comfortable," a White House statement said.

Cheney was scheduled to have a short, flexible tube called a stent put in place in his right knee in order to bypass an aneurysm which had developed in the popliteal artery, which runs behind the kneecap. During the operation, surgeons decided to install a second stent to relieve a similar condition in his left knee. The aneurysms were detected during a routine physical in July.

An aneurysm is a swelling in a weak spot in the arteries that can burst and cause internal bleeding if left untreated. Cheney's surgery was elective, and there is no indication he suffered any complications from the aneurysm before treatment.

Medical experts said that Cheney's procedure was considered experimental because stents, which are short tubes made of fabric or plastic, normally are not used in areas of the body subjected to motion such as the knee.

To insert a stent, a surgeon makes a small incision and implants the stent by means of a catheter. Such an operation generally causes less pain and fewer complications than traditional surgery.

But some doctors are concerned that the bending of joints could stress the artery or the stent itself.

"In general, most practitioners have not used them in that setting because there is a sense that they might not last very long,"' said Dr. R. Eugene Zierler, a vascular surgeon at the University of Washington. "It hasn't been proven to be efficacious or safe."

Zierler acknowledged, however, that the other procedure typically used to correct such aneurysms carries its own risks. In that procedure, a bypass is created using a graft of the patient's own tissue.

"The bypass graft is more uncomfortable and there is more risk involved," Zierler said.

Cheney's health has long been the subject of debate, especially after President Bush named him as his running mate.

Cheney, 64, has had four heart attacks, quadruple bypass surgery, two artery-clearing angioplasties and an operation to implant a pacemaker, which is designed to start automatically to regulate his heartbeat if needed.

In July, Cheney passed his overall cardiological health exam, which included an electrocardiogram and a stress test. The checkup determined that the pacemaker was working well and has never had to be activated.

Contributing: Ryan G. Murphy