The Milan hospital said Silvio Berlusconi, who served three times as Italian premier, is undergoing heart surgery.
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Berlusconi, 79, was admitted to the hospital on 5 June suffering from what his doctors said was a potentially fatal heart-valve problem.
A tax fraud conviction forced Berlusconi to give up his Senate seat, but he still leads the Forza Italia party he created when leaping into politics more than 20 years ago.
The hospital said he underwent a four-hour operation to replace a defective aortic valve. “I was anxious. Everything fine, now I am more tranquil”, the Italian news agency ANSA quoted Letta as saying.
“The operation was finished a little after midday and there were no complications in the operating theatre”, a hospital statement said, adding that Berlusconi had been transferred to an intensive care unit.
Italy’s Prime Minister Silvio Berlusconi reacts during a debate in the upper house of Parliament in Rome September 29, 2010.
Berlusconi’s 30-year-old companion, Francesca Pascale, was seen at the window of his hospital room shortly after the surgery began, looking tearful and clutching a handkerchief.
“Naturally, I am concerned”, Berlusconi wrote on his Facebook page on Monday.
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His party suffered mixed fortunes in local elections this month, with his candidate to become mayor in Rome coming fourth.
