Yeltsin’s Cardiologist Discusses Case on Russian TV

For a people whose top leaders go to extraordinary lengths to conceal their ailments and usually put politics before medicine, the man in the white lab coat was a most unexpected guest.

For 20 minutes Sunday evening, Russians watched Dr. Renat Akchurin speak on television in a smooth, professional manner about “the very serious” heart bypass operation he expects to perform on President Boris N. Yeltsin and the pressure he is feeling from his patient to hurry and get it over with.

“There is pressure from the president,” he admitted in an interview on Independent Television’s weekly “Itogi” news program. “But we stand firmly on the position that he needs a certain period of time to be prepared for it.

“We will see how the patient is prepared,” he added. “Any risk should be justified. If the risk is justified, do the operation. If it is not, don’t do silly things.”

The doctor disclosed that Yeltsin’s coronary bypass surgery, if it goes ahead, will probably be delayed from late this month--when Yeltsin wanted it done--until six to eight weeks after he completes a series of tests.

But the interview was more noteworthy as a milestone in Russia’s emergence from Soviet-era secrecy. Yevgeny Kiselev, the news program’s host, called it the first with a Kremlin doctor ever aired in Russia.

The new openness is being driven by the media. Yeltsin announced his need for surgery Sept. 5, preempting Russian reporters who had dug up the story and were about to publish it.

And Akchurin agreed to speak to “Itogi” after his own disclosures to foreign reporters about the seriousness of Yeltsin’s condition--including news of a presidential heart attack this summer--rebounded into Russian media.

Still, glasnost has its limits. The TV host did not press, and the doctor did not repeat, the statement that had infuriated the Kremlin--that the attack was serious enough to have damaged Yeltsin’s heart and might complicate surgery.

But the 50-year-old Akchurin made it clear that doctors view Yeltsin’s illness as far more serious than the Kremlin has been portraying it and that decisions about his care are no longer being made in secret or imposed on them.

Asked why he agreed to the TV interview, Akchurin said he wanted to make the point that “one should not treat this operation as elementary.”

Yeltsin has been hospitalized for tests since Sept. 13, after Akchurin examined him at a hunting lodge north of Moscow. At the time, Kremlin propagandists were portraying Yeltsin as merely tired from his stressful reelection campaign. They also reported that he had shot 40 ducks on a single expedition.

“I cannot say I was too pleased,” the doctor said in a chiding tone. “The president was hunting and fishing. For a patient in his condition, it wasn’t a rest but a burden.”

Akchurin, who is chief of cardiovascular surgery at the Cardiology Research Center near Moscow, said he has performed 1,500 heart operations, including bypass surgery eight years ago on Viktor S. Chernomyrdin, the current prime minister.

Akchurin, an ethnic Tatar born in Uzbekistan, specialized in microsurgery until 1984, when he trained in Houston for six months with Dr. Michael DeBakey, the American heart surgery pioneer. He has invited the 88-year-old DeBakey to meet this week to offer a “second opinion” on whether his team of 12 surgeons should operate on Yeltsin.