Doctor Says Open-Heart Surgery Not Needed Now : Bonner Told to Quit Smoking, Curb Cholesterol

Yelena Bonner, wife of Soviet dissident Andrei D. Sakharov, will not have to undergo open-heart surgery but will have to quit smoking and go on a strict low-cholesterol diet, her doctor said Wednesday.

Doctors at Massachusetts General Hospital performed a coronary angiogram on her Wednesday morning, a procedure that lasted about 30 minutes, said Dr. Adolph M. Hutter, director of the hospital’s coronary care unit.

“The procedure went very smoothly,” Hutter said. “Bonner is fine and we plan to let her leave the hospital (Wednesday) evening.”

Hutter confirmed that Bonner, 62, “has blockage in the coronary arteries” that supply blood to the heart, and “the distribution of the blockage is such that medical therapy would be the appropriate form of therapy for her at this time.

“She does not need an open-heart operation at this time,” he added. “Indeed, we have been beginning medical therapy and will be in the process of adjusting her therapy over the subsequent weeks.”

Bonner, who arrived at her daughter’s home in the Boston suburb of Newton on Dec. 7, received a 90-day exit visa from the Soviet Union to seek medical treatment in the West for an eye ailment and her heart trouble.

Sakharov, a Nobel peace laureate for his human rights stand, has been in internal exile in the closed city of Gorky and staged several hunger strikes to win permission for Bonner’s departure.

Hutter said that “while surgery is not indicated based on her anatomy at this time, it is certainly a possibility in the future.”

Surgery would be necessary if the medicine did not work or the blockage “progressed over subsequent years,” he said.

Follow-up in a Year

“An important part of her care will be a follow-up evaluation in a year or two, with a repeat stress test,” he said.

Hutter said “medical therapy” is a combination of “a lean weight, which she is; no smoking, which we have discussed; a low-cholesterol diet; regular exercise, and also anti-angio drugs or medicine to control angina,” chest pain caused by heart disease.

“The combination of this program is being worked out,” Hutter said. “She will have to be (in the Boston area) for a while until we can adjust the program and be sure it works.”

Hutter said he was unsure whether Bonner, who suffered a heart attack in 1983, could obtain the necessary medicine in the Soviet Union. “If not, we will send her back with an ample supply,” he said.

Hutter said Bonner, herself a doctor, took the news “matter-of-factly, as she has all along.”

As for smoking, Hutter said Bonner “is well aware of the problems of smoking.”

The test involved injecting dye into blood vessels of the heart, then making X-ray films of the fluid’s progress. The procedure is designed to determine the location and severity of the blockages in the arteries of Bonner’s heart.

Her daughter, Tatiana Yankelevich, said the family will probably wait until Bonner is released from the hospital before trying to put through another telephone call to Sakharov.