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MITRAL VALVE BLOG

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It’s the New Year, which means there’s a lot of New Year’s Resolutions being made. One of best New Year’s Resolutions you can make for yourself is to get serious about your health. You don’t have to swear off all junk food or never drink coffee again, but now is a great time to make some lifestyle changes, so you can be heart healthy this year. Studies have shown that half of heart disease deaths are caused by modifiable risk factors that people can control. Since your health is in your hands, it’s time to take charge and help your heart stay strong in 2018.

In this article, we share with you some lifestyle habits to pick up that will help you live a healthier life.

  1. Keep your weight in check – Talk with your doctor about what the healthy or ideal weight range is for someone your height, age, and gender. Try to keep between 18-25 on the BMI (body mass index) scale. A high BMI correlates to excess body fat, which is associated with a higher risk of heart disease.
  2. Eat healthy – One way to keep your weight in check is to eat healthy. This doesn’t mean your diet should be “perfect,” but you should focus on nutritious food sources. Choose fruit, vegetables, lean meats, low/non-fat dairy products, nuts, whole grains, and keep the sugar, sodium, processed foods, and alcohol to a minimum.
  3. Exercise – Exercising is also another way to keep your weight in check. Aim for either 150 minutes of moderate intensity of exercise each week or 75 minutes of vigorous intensity. The more you exercise, the more you reduce your chances of dying from heart disease.
  4. Sleep – Getting 7 to 9 hours of sleep helps in lowering a person’s risk of heart disease.
  5. Quit smoking – Tobacco smoke is responsible for 30 percent of heart disease deaths in the United States each year.
  6. Monitor blood pressure – High blood pressure is the leading cause of death around the world and a risk factor of heart disease. Lower blood pressure leads people to live longer lives. Find out where your blood pressure should be numerically, and keep an eye on it, whether at home or with your doctor. If you need to be on blood pressure medication, take it!
  7. Drink plenty of water – Higher intakes of water have correlated with lower risk of heart disease.
  8. Get the influenza vaccine – This vaccine is encouraged for people with heart disease and heart failure; it is known to offer protection against atrial fibrillation.
  9. Stress less – Find ways to reduce stress. Heart disease is often associated with stressful life events.

If you suffer from heart disease, it’s time to talk to a heart valve surgeon about your options. Dr. Peter Mikhail is a heart valve surgeon who specializes in mitral valve surgery and TAVR. To book a consult, click here or call 727-312-4844. He is based in New Port Richey, Florida, and treats patients in the Tampa and Clearwater areas.


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As a heart valve disease patient, there’s a chance you may need heart valve surgery. One of the decisions you will have to make is regarding your replacement valve. Do you need a mechanical valve or a biological tissue valve? You will come to this decision with your doctor, based on a lot of factors. In this article, we will focus on some facts about mechanical valves.

A mechanical valve can last inside a person’s body for more than 20 years. It is made from pyrolytic carbon. With a mechanical valve, you will (most likely) only need valve surgery once, and never have to replace the valve. There are two common types of mechanical valves: tilting disc valves and bileaflet valves. Unfortunately, mechanical valves can cause blood clots, so a patient needs to be on blood thinners, like Coumadin, for the rest of his or her life to prevent clots from forming in the valve.

Mechanical valves are known to be extremely durable. Since patients with mechanical valves are less likely to need a repeat operation these types of valves are good for people under 60 years of age.
There are some disadvantages to consider when thinking about getting a mechanical valve. For example, some people may not want to be on blood thinners for the rest of their lives. When you’re on blood thinners, you will have to be monitored for life and you have a higher risk of bleeding. Dietary changes may also have to be made to maintain consistent levels of vitamin K in the body. Contact sports and other risky activities that may result in bleeding should be avoided. Sometimes, mechanical valves can be heard when they open and close, but most patients are not disturbed by the noise; however, this can be seen as a disadvantage by some patients.
If the patient is already on blood thinning medications (due to blood clots or atrial fibrillation), choosing a mechanical heart valve may make more sense. Patients with conditions such as hyperparathyroidism are better off with a mechanical valve.

Your heart valve surgeon, like Dr. Peter Mikhail, will discuss your valve choices with you by going through all the factors so you have a good understanding of all the options, advantages, and disadvantages. Dr. Mikhail wants to work with his patients to make an informed, educated decision.

If you’re looking for a cardiac surgeon to perform your heart valve surgery and discuss valve replacement options, book a consult with Dr. Peter Mikhail who is based in New Port Richey, Florida. Dr. Mikhail is one of the foremost authorities and specialists in mitral valve surgery; he also performs TAVR and mini-AVR. To book a consultation, click here or call his office at 727-312-4844.

 


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Heart disease is scary. Just the thought that your heart valves are malfunctioning and that your risk of having a heart attack is increased can frighten anyone. You wonder if the disease will worsen, or, is it possible for the disease to be reversed? In short, heart disease is treatable, and people can live long, healthy lives by changing their lifestyles and treatment, but there is no miracle cure to reverse heart disease. You may be able to slow it down and undo some of the damage, but probably not all.

Many patients look for miracle cures because they want the disease to be gone. Overall, these days patients have many options to treat and stabilize heart disease. Unfortunately, heart disease sneaks up on many people. For years, they may have eaten poorly, forgotten to exercise, and/or smoked. These bad habits can catch up to you. Unfortunately, there is no ideal diet or lifestyle to ward off heart disease. The reality is, you have to make drastic lifestyle changes and stick to them on a daily basis; you have to choose a lifestyle that will be maintainable and sustainable over time.

If you smoke, you should stop. Pay attention to your blood pressure and cholesterol levels. Keep up with your medicines. Start exercising (if you don’t); aim for at least 30 minutes of exercise at least 3 to 4 times a week.

Since there is no miracle cure for this disease yet, the goal is to stabilize the disease, then patients may see regression over time. Treatments and lifestyle changes combined can help stabilize the disease.

If your doctor prescribes a medication, take it. There are many people out there who claim the cure to heart disease isn’t in medicine and that medicine is evil or isn’t good for your body. Although medicine isn’t always needed, if a doctor prescribes a medicine for you, talk about all the pros and cons and determine if this is the best route to keep this disease stabilized.

Just like most things in life, stabilizing heart disease is hard work. Changing your lifestyle will not be easy, neither is it a quick fix. Educate yourself on the best habits and treatments out there.

Modern day medicines and treatments have improved outcomes for heart disease patients. Patients can live longer, happier, healthier lives.  These days, the outlook for heart disease patients is much more hopeful. And if you don’t have heart disease, prevention is key.

Bottom line, you cannot cure heart disease, but you can slow down its progression.

If you suffer from heart valve disease and believe you need surgery, it’s time to talk to a heart valve surgeon about your options. Dr. Peter Mikhail is a heart valve surgeon who specializes in mitral valve surgery and TAVR. To book a consult, click here or call 727-312-4844. He is based in New Port Richey, Florida, and treats patients in the Tampa and Clearwater areas.


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If a person has heart valve disease, it’s not uncommon to also experience other conditions or disorders at the same time, including atrial fibrillation and coronary artery disease.  Another disease that can affect patients with heart valve disease is an aortic aneurysm. What is an aortic aneurysm? An aortic aneurysm is when the walls of the aorta (the largest blood vessel in the body) begin to weaken and bulge. This aneurysm can result in a blood leak into the body if it bursts; however not all aortic aneurysms burst. Aortic aneurysms also can force blood away from organs and tissues resulting in heart attacks, kidney damage, stroke, and death.

Bicuspid aortic valve disease is often linked to ascending aortic and aortic root aneurysms. Patients with bicuspid aortic valve disease should also be evaluated for aortic aneurysms.

An aortic aneurysm can appear in the chest (thoracic aortic aneurysm) or in the abdomen (abdominal aortic aneurysm). Chest aneurysms often develop due to genetics, but other causes include high blood pressure, high cholesterol, plaque buildup, or a traumatic injury. With this type of aneurysm, the symptoms are often not present until the aneurysm is large or bursts. Symptoms that a person may experience can include chest pain, back pain, difficulty breathing and/or swallowing, and shortness of breath.

Often, there are no signs of an abdominal aortic aneurysm; however, some people may have back pain, deep pain on the side of the abdomen, or a throbbing sensation near the navel. If this aneurysm bursts, a person can feel sick and vomit, become sweaty, become dizzy, or feel extreme pain in the abdomen or the stomach. Doctors are not certain what causes abdominal aortic aneurysms but some things that may contribute to its development include hardening of the arteries, smoking, high blood pressure, and genetics.

In some cases, aneurysms can actually cause aortic valve disease or dysfunction. How? The aortic root is connected to the aortic valve and the stretching of the root can stretch the valve, which can lead to valve leakage or insufficiency. Patients with aortic aneurysms usually get checked for aortic valve problems, too.

Aneurysms often take years to grow, and they should be taken seriously. To prevent the development of an aneurysm, it’s best to maintain a good blood pressure and to avoid activities and exercise that require intense straining.

If you have an aortic aneurysm and aortic valve disease, talk to a valve specialist to determine a specialized treatment plan for your condition. Dr. Peter Mikhail is a cardiac surgeon who specializes in aortic valve surgery. To book a consult, click here or call 727-312-4844.


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Aortic stenosis is a condition that is growing as the U.S. population grows. Right now, it is estimated that 2.5 million Americans over 75 suffer from this heart valve disease, which accounts for 12.4 percent of the population.  Between now and 2050, the elderly population will more than double to around 80 million.

Aortic stenosis affects men more often than women. In fact, 80 percent of adults with aortic stenosis are male. What is aortic stenosis exactly? With this condition, the aortic valve’s flaps (cusps) have thickened or become stiff and could possibly fuse together, which narrows the valve. The valve’s opening becomes narrowed and blocks/reduces blood flow from the heart into the aorta and to the rest of the body.

A person with aortic stenosis will experience the following symptoms: shortness of breath, heart murmur, dizziness, fainting, chest pain, chest tightness, irregular heartbeat, and swelling of the ankles and feet.

The disease is often misdiagnosed and undertreated. A severe case of aortic stenosis can be fatal; some doctors refer to the disease as a “silent killer.”  It is a progressive disorder, and the onset of the symptoms and progression will vary from patient to patient. As a person gets older, the aortic valve disease will continue to progress, regardless of what the patient does or doesn’t do.

Since nothing can reduce the progression of this disease, patients are instructed to visit their cardiologist annually, and have an echocardiogram to evaluate is the disease is becoming more severe.  Aortic stenosis has three progression stages: mild, moderate, and severe.  As stated earlier, a person can experience an array of different symptoms with this disease. If a person is experiencing symptoms, it is often a sign of a progression of the degenerative process, and the person should have the doctor assess them immediately.

If a person gets to the point in which he or she needs an aortic valve replacement, they have more options for surgery than ever before. These days, there are less invasive approaches to aortic valve replacement such as transcatheter aortic valve replacement (TAVR).  TAVR is good for people who have been diagnosed with severe aortic valve disease and are at an intermediate or high risk for open heart surgery. Most people who have this procedure are in their 70s or 80s. In this surgery the doctor inserts a catheter in a leg or chest and guides it to the heart. A replacement valve is inserted through the catheter up to the heart.

Do you suffer from aortic stenosis? If you need an aortic valve repair or an aortic valve replacement, Dr. Mikhail is a cardiac surgeon based in New Port Richey, Florida, who specializes in heart valve surgery. To book a consult, click here or call 727-312-4844.

 


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Heart disease is the leading cause of death in the United States. Fortunately, people can lower their risk of developing heart disease by monitoring their diets. Overall, a diet low in saturated fats and low cholesterol, along with many other dietary factors, help lower one’s risk. Over the years, there have been many studies and articles have been written on “heart-healthy” foods for people to add in their diets. These foods are known to have anti-inflammatory properties, lower bad cholesterol, lower blood pressure, have antioxidants, and raise good cholesterol – all of which can help ward off heart disease. Throughout the years, soy products have been cited as a food source that lowers blood cholesterol levels and help provide other cardiovascular benefits. However, this has now changed.

In November, the FDA announced to revoke an authorized health claim about soy and heart disease. For the first time ever, the FDA is proposing a revocation. Back in 1999, the FDA approved the claim (to be used on packaged soy products) that soy protein can help reduce heart disease. Now, they’re changing their tune.

The Director of the FDA’s Center for Food Safety and Applied Nutrition, Susan Mayne, said in a released statement, “While some evidence continues to suggest a relationship between soy protein and a reduced risk of heart disease—including evidence reviewed by the FDA when the claim was authorized—the totality of currently available scientific evidence calls into question the certainty of this relationship.”

Apparently, after the FDA approved this health claim in 1999, there have been inconsistent findings regarding the ability of soy protein to help lower LDL (“bad”) cholesterol. Now, this doesn’t mean soy consumption increases a person’s heart disease risk, it just doesn’t reduce it.

This soy claim may change from an “authorized health claim” to a “qualified health claim.” A qualified health claim requires a lower scientific standard of evidence to explain the limited (but not definite) evidence linking soy protein intake with heart disease risk reduction.

The FDA will go through a full, official revocation process that will allow the public and industry stakeholders a chance to submit comments to the FDA to persuade it to keep the authorization. People can comment until January 18, 2018.

If you’re looking for heart-healthy foods that can help reduce one’s risk of developing heart disease, choose foods like nuts, salmon, berries, oatmeal, avocado, spinach, tuna, and olive oil.

If you are suffering from heart valve disease, Dr. Peter Mikhail is a thoracic and cardiac surgeon in New Port Richey, Florida who performs mitral valve surgery and TAVR.  He also treats patients in the Tampa and Clearwater areas. Dr. Mikhail advises his patients on the best diets based on their condition. To book a consult with Dr. Mikhail, click here or call his office at 727-312-4844.

 


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Did you know the mitral valve is made up of five parts? The five parts are the leaflets, the annulus, the chords, the papillary muscles, and the ventricle wall. Together, these parts make up a suspension system for the leaflets to open and close properly. For this article, we will focus on discussing the mitral valve chord (or chordae).

The chordae look like chords and they connect the leaflets to the papillary muscles. These cords are responsible for the end-systolic position of the leaflets. There are marginal (primary) chordae, intermediate (secondary chordae) and basal (tertiary chordate). Marginal chordae function to prevent the prolapse of the margin of the leaflet. Intermediate chordae relieve valvular tissue of excess tension, and help preserve ventricular shape and function. Basal chordae connect the leaflet base and the mitral annulus to the papillary muscles.

The chords can malfunction by rupturing from an infection or prolonged elongation due to a possible collagen disorder. If the mitral chords rupture, they will leak blood, which develops into mitral regurgitation. Mitral regurgitation is a form of mitral valve disease or heart disease. The blood is leaking back into the left atrium of the heart. If left untreated, the heart could become enlarged, heart muscle damage could occur, or the person can develop congestive heart failure. If these chords rupture, a person may experience heart palpitations, shortness of breath, difficulty breathing during exercise, and fatigue as symptoms.

The mitral chords can be repaired by removing the damaged chords and the attached leaflet segments and replacing them with a mitral (annuloplasty) ring. If the mitral valve regurgitation isn’t severe, a patient can be treated with prescription medications.

During a mitral valve chord repair, the surgeon ensures that the blood in the valve will be moving in one direction again. The earlier that mitral valve disease is caught the better a person’s chances are for a full recovery without damage to their heart or lungs.

If you suffer from mitral valve disease, it’s time to talk to a mitral heart valve surgeon about your options. Dr. Peter Mikhail is a mitral valve surgeon who specializes in heart valve surgery. To book a consult, click here or call 727-312-4844. He is based in New Port Richey, Florida, and treats patients in the Tampa and Clearwater areas.


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Heart surgery is major surgery, even when it’s a minimally-invasive procedure.  After such a major surgery, a person will certainly need lots of rest and relaxation to recover properly.  Although you know your heart was just repaired, it can be hard to exercise patience. Who doesn’t want to get back to their normal routine as soon as possible? Even though you asked the doctor endless post-op questions prior to surgery, you still begin to wonder when you’ll be able to return to your normal daily activities.

Recovery can be hard both physically and mentally.  Your recovery is unique because you are a unique individual. Every patient heals differently and at a different rate.

For the first week post op, you most likely will be in the hospital. You will spend one to two days in the ICU and then be moved to a regular hospital room for the remainder of the week. During your hospital stay you will be walking regularly and gradually increasing physical activity, so you will be able to walk and go up and down stairs before you head home.

Before sending you home, the doctor will give you recovery instructions, such as watching for any signs of infection, incision care, pain management, and post-op side effects. You will still be sore, but may no longer be on pain meds. The doctor will determine how much physical activity you can do, and will encourage lots of rest throughout the day. The doctor may recommend cardiac rehabilitation, as well as permanent lifestyle changes when it comes to diet, physical activities, tobacco usage, and stress management to promote healing and recovery. If something hurts, stop doing it. Focus on performing activities that don’t hurt you.

Around the fourth or fifth week post-op, you will be getting close to being back to your normal activities. You can be back to work, can travel and celebrate a holiday without feeling awful. Although you are still not 100%, you will feel significantly better now.

Looking for a cardiac surgeon to perform your heart valve surgery? This is Dr. Peter Mikhail’s specialty. Dr. Mikhail is a cardiac surgeon based in New Port Richey, FL, and treats patients in Tampa and Clearwater. He is considered one of the foremost authorities and specialists in mitral valve surgery and TAVR. To book a consult, click here or call 727-312-4844.


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Your doctor just told you that you have a calcified heart valve. One of your heart valves is stenotic. You potentially may need it repaired, or completely replaced. What does this exactly mean? How is there calcium build up on my valve? What is a stenotic valve? Is surgery the only option?

Upon being diagnosed with a type of heart valve disease, a lot of questions are probably buzzing around in your head – as they should be. Remember, never hold back from asking your doctor questions. You have just been diagnosed with mitral valve stenosis, which can be a very serious condition if left untreated. So, you should feel the need to ask and learn everything about this disease.

For this article, we address heart valve calcification/mitral valve stenosis to give you an overview of this disease. First, mitral valve disease is when the mitral valve (located between the left atrium and left ventricle heart chambers) is no longer working properly. When the valve isn’t functioning properly, the heart is unable to pump enough blood out of the left ventricular chamber to give the body oxygen-filled blood.  There are different types of mitral valve disease, but for this article, we will focus on mitral valve stenosis (obstruction).

Mitral valve stenosis is when the valve’s opening has narrowed and the valve’s flaps have thickened or stiffened; the flaps may have even fused together, which causes the narrowing or blockage of the valve. When this occurs, blood backs up in the left atrium of the heart instead of flowing to the left ventricle.

When the heart valve becomes calcified, there is a large amount of calcium on the valve, and it has been building up for many years. When the valve becomes calcified, the flaps become stiff and the valve narrows and becomes stenotic. How does this happen? Well, there are a few reasons. Some people’s valves begin to calcify just from age and wear and tear of the valves. Some people are born with congenital valve abnormalities. Some people’s lifestyle choices and history (smoking, chronic kidney disease, diabetes, elevated cholesterol) can lead to calcified valves. Some people’s valves become calcified through atherosclerosis, which is a process that causes arterial blockages in different parts of the body.

A person who has severe stenosis and calcification will experience shortness of breath, chest pain and lightheadedness.

With moderate to severe cases, surgery (valve repair or valve replacement) is usually suggested as the best option to fix the valve and eliminate symptoms. Patients can choose with their doctor whether they want a mechanical or biological heart valve. It’s good to note that even if you get your heart valve repaired or replaced, a biological valve can calcify again.

Unfortunately, there Is no known way to truly prevent the valves from calcifying. However, if a person does have a calcified valve, he or she should be under the watch of a cardiologist, to assess if the valve worsens over time. The cardiologist will most likely want to follow up in 6 months to a year. Treatment, such as surgery, will be suggested when deemed necessary.

Are you suffering from valve stenosis or calcification and looking for a surgeon? Dr. Peter Mikhail is a cardiac surgeon who specializes in performing surgeries on mitral and aortic valves. Dr. Mikhail is based in New Port Richey, FL, and treats patients in the Tampa and Clearwater areas. To book a consult, click here or call 727-312-4844.


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To be blunt, surgery is scary. Even the toughest of us get nervous before going under the knife.  When on the table, we are literally putting our lives into someone else’s hands. We have the hope that the surgeon will be able to “fix” us, heal us, and make us better. Surgery can become even more scary when it involves the heart. Heart valve surgery is a big-time surgery, so it’s no wonder patients have many questions and concerns about before, during, and after the procedure. With any surgery, there are risks, so it’s best to know as much as possible about the surgery before setting a date.

For this article, we focus on what you, as the patient, can do to help yourself have the best surgery and post-op as possible. Below, we’ve listed some helpful tips and ideas for you to think about and question before having heart valve surgery, including mitral valve surgery, TAVR, and mini-AVR.

  1. Get to know your cardiac surgeon. What is his or her background? Specialty? How many heart valve surgeries has he or she performed? Do your research.
  2. Choose a cardiac surgeon with a specialty in mitral valves and aortic valves.
  3. Look for a cardiac surgeon who performs more than 20 mitral valve or aortic valve surgeries throughout the year.
  4. Look at pictures and testimonials of your doctor’s past patients. Specifically, look at patients’ stories who are like yours.
  5. Ask questions. Ask as many as you want. To ensure you’ll receive all the information you need, jot your questions down. As a patient, you have the right to know what the surgery will entail and what you will have to experience before, during, and after the surgery.
  6. Make a checklist about all the things you will need help with post-surgery. With this list, you’ll be able to ask family and friends ahead of time to help you with everything from running an errand to vacuuming. You don’t want to get stuck doing anything by yourself that could potentially delay your recovery or harm you.
  7. Think about things to bring to the hospital for you to use post-surgery. Such items may include your own pillow, dry shampoo, feminine products, iPad/phone, books, nightgowns, shorts.

Although this is just a brief list, it gives you an idea of some topics to think about when considering or preparing to have heart valve surgery.

If you’re thinking about having mitral valve surgery or TAVR, Dr. Peter Mikhail is a cardiac surgeon who specializes in these surgeries. Dr. Mikhail is based in New Port Richey, FL, and treats patients in Tampa and Clearwater. To book an appointment, click here or call 727-312-4844.

 

 


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Dr. Peter Mikhail is a thoracic and cardiac surgeon in Tampa, Clearwater, and New Port Richey, Florida. Dr. Mikhail is Board Certified by the American Board of Surgery, The American Board of Thoracic Surgery and The Royal College of Physicians and Surgeons of Canada.

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