Dick Clark died a day after prostate surgery

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Hollywood producer and television legend Dick Clark died of a heart attack a day after having prostate surgery, according to a death certificate obtained by CNN.

Clark died last Wednesday at St. John’s Health Center in Santa Monica, California. The day before his death, he had an operation to relieve “acute urinary retention,” an inability to urinate.

“It’s a very painful condition,” says Dr. Kevin McVary, professor of urology at Northwestern University’s Feinberg School of Medicine in Chicago.

The operation is “exceedingly safe” according to McVary, a spokesman with the American Urological Association.

“The mortality rate is less than one in 1,000. That’s very low risk,” he says.

The death certificate lists acute myocardial infarction and coronary artery disease as the causes of death. In December 2004, Clark suffered what was then described as "a mild stroke," just months after announcing he had been diagnosed with Type 2 diabetes.

Patients with this kind of health history are usually screened by a doctor to test whether their heart is strong enough to withstand surgery, McVary says.

The surgery, known as transurethral resection of the prostate, is considered lower risk because it doesn’t involve an external incision. Instead, doctors insert a surgical tool through the tip of the penis and into the urethra, and then cut away prostate tissue to unblock the flow of urine.

It’s not known why Clark had a heart attack after this procedure. Surgery can be risky for cardiac patients. Anesthesia, for example, can be difficult on the heart, and so can blood pressure fluctuations that occur during surgery.

“Having surgery is a stressful event,” says Dr. Kenneth Rosenfield, an interventional cardiologist at Massachusetts General Hospital in Boston. “It might have been enough to tip him over.”