State: Graham needs heart surgery

Graham needs heart surgery

The senator now won't decide until mid March whether to enter the race for the presidential nomination.

By BILL ADAIR and ADAM C. SMITH

WASHINGTON -- Sen. Bob Graham will undergo open-heart surgery early next month to replace a faulty aortic valve, the senator and his cardiologist announced Thursday.

Graham, 66, who had been expected to enter the race soon for the 2004 Democratic presidential nomination, said he will now wait until mid March to decide whether to run.

"I would have preferred to have spent February on the campaign trail," Graham said Thursday at a press conference in which he was accompanied by his wife, Adele, and his cardiologist, Dr. Warren Laskey of Bethesda Naval Medical Center in Maryland. "That's not an option that's open to me."

Graham and his advisers had been discussing launching his campaign in Tallahassee on Feb. 3, but now he will be in the Bethesda hospital for heart surgery. His aortic valve will be replaced with a mechanical valve.

Political analysts interpreted news of the upcoming surgery as a setback, but not necessarily a deal-breaker, for Graham's prospective candidacy.

"We're talking about what is generally considered a pretty routine procedure," said Norman Ornstein, resident scholar with the American Enterprise Institute, a conservative think tank. Far more problematic, Ornstein suggested, was the delay the surgery will mean in getting into the race, raising money and organizing campaigns.

Graham acknowledged that the heart procedure was "not a positive thing" for his bid, "but I don't think it's a significant negative." He noted that President Clinton didn't begin campaigning until the fall before the 1992 primaries.

If he runs, it will help his campaign to "have had this thing behind me," he said. "It's not something that will require urgent attention in January or February in the midst of the campaign."

The aortic valve, which regulates blood flow from the heart to the body, can collect calcium deposits that narrow the opening, making it harder for blood to flow. The deposits also prevent it from closing fully, which allows blood to leak out.

"Aortic valve replacement is a common procedure that provides people with decades of healthy living," Dr. John F. Eisold, Congress' attending physician, wrote in a letter to Graham. "While the surgery, hospitalization and recovery are inconvenient, you can expect to return to a full schedule without any difficulty."

Graham and his doctors have been aware of the faulty valve since the mid 1990s, but the condition was not urgent and doctors said a replacement would not be needed for years. Exams last summer and fall indicated the valve was more impaired and the physicians decided to monitor it more closely.

When Graham began thinking about whether to run for president, he scheduled a cardiac catheterization, in which the heart is examined by a miniature camera. That procedure Tuesday at the Bethesda medical center revealed that the valve was significantly impaired and needed to be replaced soon. After a conference call with his doctors Wednesday, Graham decided to have the procedure done the first week in February.

The three-term Democrat said he has recently been feeling fatigued and short of breath, which can be symptoms of valve problems. The symptoms were visible to a reporter last week after Graham became short of breath while climbing stairs in his Senate office and walking to an elevator.

"I have felt a little less vigorous than I normally do," Graham said Thursday. "I'm eager to get back to my normal state of energy."

The surgery is likely to take about two hours and Graham will be hospitalized about one week. He will then need about one month at home to fully recover, Laskey said.

At the press conference, the doctor gave a technical description of possible complications and ended with the ominous possibility ". . . or worse."

Demonstrating the good spirits that characterized his demeanor throughout the press conference, Graham then chimed in: "I think that means you die." (Medical experts set the death rate among patients who have valve replacement surgery for mild symptoms while in otherwise good health at 1 to 2 percent.)

If Graham ultimately decides to run, a delay could be costly. Other Democrats have been aggressively raising money, campaigning and organizing for the past year. Many observers think Graham can ill afford to wait much longer to get started.

"The primary process is a yearlong marathon. If you spot the other candidates a month head start, it's going to be tough to catch up. It's doable, but it's not the way you want to start out," said Dick Harpootlian, Democratic Party chairman in South Carolina, which follows New Hampshire with a February 2004 primary.

"Every candidate who has announced or even hinted that they were going to run has been to South Carolina and begun organizing here," said Harpootlian, who thinks Graham could have strong potential in the first Southern primary state, though he is now largely unknown.

With few voters paying much attention to the race at this point, Graham's lack of visibility for the next month poses less of a problem than does the delay in resolving campaign logistics. Top campaign managers, grass-roots operatives and fundraisers could be locked up by other Democrats by the time he gets in the race.

What's more, he needs to raise some $20-million for the campaign, mostly in $2,000 increments. Every day he's not in the race makes that job harder, even for a senator whose home state tends to be a huge source of campaign money.

"He's losing one-twelfth of the time he needs to raise money and to campaign," said University of Virginia political scientist Larry Sabato. "He's not too late so that he can't compete, but he is tardy enough that he is penalized."

Graham's advisers have planned on raising half his money from Florida, but even before Thursday's news, some Florida Democrats had complained that he's taking too long to make an announcement.

"It's going to be incumbent on us to get on the phone and see if we can keep the contributor community in place," said Buddy Shorstein, Graham's former chief of staff and closest political adviser.

Chris Korge, a Graham backer and major fundraiser from Miami, doubted a month would make much difference, particularly if Graham concentrates on primaries after New Hampshire.

"A one-month delay by Graham means more for the other candidates," Korge said, noting that most Florida fundraisers are waiting for Graham before committing to other candidates. "He has effectively taken the nation's third-biggest fundraising ground off the plate for everybody."

Even before his announcement Thursday, it was likely that Graham's age would be a factor in the campaign. He is not only the oldest candidate likely to enter the race, but if he were to win, Graham would be the oldest president since Ronald Reagan.

Several political observers doubted Graham's health would become a significant issue, so long as Graham appeared vigorous on the campaign trail.

Graham said Thursday that he was still energetic.

"I'm a fire horse ready to get in a harness," he said, but "I recognize that I'll have to stay in the barn longer."

When Sen. Bill Bradley was a presidential candidate two years ago, he revealed that he was having occasional episodes of an irregular heartbeat. But the episodes do not appear to have been much of a factor in his campaign or his decision to drop out of the race when Vice President Al Gore's lead was insurmountable.

Vice President Dick Cheney had three heart attacks before he was a vice presidential candidate and then a smaller one shortly after the 2000 election. Two years ago, doctors inserted a device in his chest that acts as a pacemaker to restore his heart to normal rhythm if it begins beating irregularly. The device also is a defibrillator that can give him a live-saving jolt if he has serious heart trouble.

Cheney's heart problems did not become much of an issue in the 2000 campaign, but it's likely they would be in the next election, if Cheney remains President Bush's running mate. Critics have questioned whether someone with a history of heart problems should be in such a high office. But cardiologists often cite Cheney's recovery as proof that heart disease can be successfully treated.

Asked if heart problems would hurt his presidential chances, Graham said, "The vice president had much more extensive heart problems than I've had and he was selected to run and was elected."

Graham said Rep. Claude Pepper had a similar valve replacement and then lived for 20 years before dying of cancer.

Graham said he had been interviewing people for key campaign jobs and was close to signing contracts with a few people. Those decisions will be on hold until mid March, when he decides whether to run.

-- Times researcher Cathy Wos contributed to this report.