Italy's ex-prime minister Silvio Berlusconi has left hospital three weeks after undergoing heart surgery.

The 79-year-old said he hopes to still be useful to Italians but that he is gravely concerned about the state of Italy, Europe and the world.

Mr Berlusconi walked slowly and gingerly, clutching the shoulder of an aide as he emerged from the San Raffaele clinic in Milan.

The media mogul underwent surgery to replace a malfunctioning heart valve on June 14.

He told reporters outside the hospital that he was feeling better but that the ordeal had been "very very painful".

He said during his time in the hospital, he was gravely concerned about the "ferocious, absurd terrorism" that was afflicting the world and the possible disintegration of the 28-nation European Union after the United Kingdom's vote to leave.

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