Silvio Berlusconi to undergo heart surgery

Dr Alberto Zangrillo said the 79-year-old billionaire businessman "risked dying”, indicating a condition more serious thaninitial reports had suggested.

Berlusconi, who had a pacemaker in 2006, called Zangrillo on Sunday morning from Rome to report the ailment. Zangrillo said he advised his patient to return to Milan and go directly to the hospital.

"He obeyed me in part. He wanted to exercise his right to vote and he only came to us in the afternoon,” the doctor said. "At the beginning he didn’t want to believe it. For a man who wants to live to be 130, this is a very unpleasant jolt.”

Zangrillo said a team of doctors at the multidisciplinary San Raffaele clinic ran several tests on Berlusconi and diagnosed severe aortic insufficiency, which involves a leaking of the aortic valve of the heart, causing blood to flow in the reverse direction. He said Berlusconi was being treated "like all other patients”.

Berlusconi will undergo the four-hour operation to substitute the valve by the middle of next week, after which he will be in intensive care for up to two days before a period of rehabilitation that will last about a month. Zangrillo said the former PM would then feel "better than before”.

Berlusconi no longer holds public office due to a 2013 tax fraud conviction, but remains the head of the Forza Italia party and has been active in ongoing mayoral campaigns.