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You just had heart valve surgery. Be proud of yourself and your body for undergoing some major surgery to enable you to lead a healthier, longer life. But, now what? What do you do after heart valve surgery? How do you take care of your heart? We want to share some basic things you will need to do to stay healthy after heart valve surgery.

Right after surgery, you will be told to walk regularly, perform breathing exercises and gradually increase activity. Your doctor will give you recovery instructions, such as to watch for any signs of infection, incision care, pain management, and post-op side effects. Your doctor will determine when you can return to daily activities. Cardiac rehabilitation (to help improve health and help with recovery) may be recommended by your doctor, as well as permanent lifestyle changes when it comes to diet, physical activities, tobacco usage, and stress management.

If you had mitral valve surgery recently or even a few years back, you may be wondering “How do I take care of myself going forward?” If your repair went well, your doctor will check up on you periodically. If he or she doesn’t hear anything irregular through a stethoscope, no extra testing will be needed, especially if you feel fine and have no alarming symptoms. If you’ve had an artificial valve put in, your doctor will pay attention to its wear and tear and know when it needs to be replaced again.

If you’ve had a good repair by a good surgeon, your heart (and new valves) should be long-lasting. There is no need to repeat unnecessary tests if you feel fine and the doctor hears or sees no problem during a physical exam.

Your doctor will continue to recommend that you eat well, watch salt intake, watch your weight, eat lots of fruits and vegetables, and aim to do some form of exercise regularly.

If you stick to healthy diet and exercise choices and get checked up once or twice a year by your doctor, you will continue to keep your heart happy and healthy.

If you suffer from heart disease, it’s time to talk to a heart valve surgeon about your options. If you’re looking for a great heart valve surgeon, Dr. Peter Mikhail 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.


Survival and mortality rates isn’t a subject anyone is excited to talk about, but we must talk about it when it comes to having heart valve disease and surgery.

There are potential risks when undergoing any surgery, even a minimally-invasive surgery. When it comes to heart valve surgery, there isn’t a set percentage, per se, for the survival or mortality rates, because it’s very situational; the numbers depend on the patients. For example, a healthy 50-year-old who needs to undergo heart valve surgery might have a 0.5 percent risk of death (1 out of 200), but an 85-year-old patient with other health problems could have a 10 to 15 percent (or more) mortality rate. However, to give you a ballpark average, according to The Society of Thoracic Surgeons the mortality rate for heart valve surgery is about 1.7 percent. In some clinics, this percentage is even lower.

If you’re having heart valve issues, an experienced heart valve surgeon, like Dr. Peter Mikhail, will meet with you, give you an exam and look at your history to determine if you are a candidate for mitral valve surgery, mini-AVR or TAVR. Even if you are a good candidate, the doctor will make you aware of the risks that come along with the procedure. If the procedure is too risky for you, the doctor will not suggest surgery.

If a person with severe heart disease is a candidate for surgery, then surgery is highly recommended. Without surgery, the patient could risk an early death. For example, a person who has severe aortic stenosis only has an average 50 percent survival rate after 2 years with the severe disease and only 20 percent after five years if he or she goes without surgery.

Each year, more than 700,000 heart surgeries take place globally, and more than 250,000 of these surgeries are valve repairs and replacements. With such a large number of people undergoing this surgery you don’t have to worry about having some new, untested surgical procedure.

If you’re hesitant about having heart valve surgery, we understand. You want to look for a surgeon who will answer all your questions, and who is extremely experienced in this type of surgery. Dr. Peter Mikhail, who is based in New Port Richey, Florida, is one of the foremost authorities and specialists in mitral valve surgery, mini-AVR and TAVR. To book a consultation, click here or call his office at 727-312-4844.


Heart valve surgery is a life-saving procedure. Today there are minimally-invasive mitral valve and aortic valve surgeries, so the patient has a shorter recovery period. However, the possibility of re-operations on the heart valve does occur. Why? Leaking can occur. Also, the valves are not everlasting and are subject to wear and tear over the years.

A mechanical valve can last inside a person’s body for more than 20 years. The valves are made from pyrolytic carbon. Most likely, you will need valve surgery only once, and never have to replace the valve. That is, unless you get this surgery done at a younger age. A biological tissue valve often has to be replaced because it lasts only 10 to 18 years. A patient’s life expectancy is strongly considered with this valve, since he or she will most likely need another surgery when the first tissue valve degenerates. This type of valve is recommended for patients 60 years old or older.

Nothing is perfect; sometimes, patients have leakage again just a few months after their surgery while others may never have a leak. Some patients will need a repair while others will need a whole new replacement. If a patient leaks soon after the surgery, this is called an “early failure.” How the doctor will fix this new leak will depend on what type of valve disease the person had to begin with. For example, mitral valve prolapse is almost always re-repairable. The doctor will examine you and do a workup to see if the time is right to do a re-operation. Mitral valves are living pieces of tissue, so the surgeon aims to preserve them whenever possible.

Re-operations have become safer in the last decade. You want to make sure you’re working with a heart valve surgeon who is experienced in re-operations. Re-repairs require extensive experience. It is a “super” specialty. Re-operations are challenging because after the first operation, the heart and tissues healed with scarring and tissues are stuck together, so the risks of injury to the heart and blood vessels when getting into the chest is higher. Also, scarring makes re-operating on the valves more challenging.

Re-repairs are done on:

  • Patients who had a previous heart operation unrelated to the heart valves, but now need heart valve surgery.
  • Patients who had a mitral valve repair who developed a new leak in the valve or the valve was unable to be fully corrected in the first operation.
  • Patients who had a valve replacement who now need a new valve replacement, because the previous valve is worn out, not working properly, or is infected.

If you’re looking for a cardiac surgeon to perform your heart valve surgery and discuss valve replacement or repair 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 and he also performs mini-AVR and TAVR. To book a consultation, click here or call his office at 727-312-4844.


February is American Heart Month! This is a great time to commit to a heart-healthy lifestyle and make small changes that will lead you to living a longer, healthier life.

Heart disease is the leading cause of death in both men and women. African American men are at the highest risk for heart disease. In America, one woman dies from heart disease every 80 seconds. What can both men and women do to make a difference in their heart health?

  • Book an appointment with your doctor to talk about your heart health. See if your diet and exercise regimen should be changed. Let your doctor know of any heart problems in your family’s history or any strange symptoms you’ve had or currently have.
  • Add exercise into your daily routine. Start off with a 15-minute walk a few times a week. Gradually work your way up to 30 minutes a few times per week.
  • Eat heart-healthy foods: lean meats, vegetables, fruits, whole grains. Avoid sugary treats, high sodium foods and fried foods.
  • Quit smoking. Quitting smoking can drastically cut your risk for both heart disease and stroke.
  • Talk to your doctor about medications you may need to help your heart, including high blood pressure and cholesterol medicines.

During the month of February, the American Heart Association wants to remind Americans to focus on their hearts to encourage a culture of health where making healthy choices is easy. The first American Heart Month, which took place in February 1964, was proclaimed by President Lyndon B. Johnson via Proclamation 3566 on December 30, 1963. Back then, more than half of American deaths were caused by cardiovascular disease.

This disease, unfortunately, still claims the lives of 17.3 million people each year across the globe. Fortunately, 80 percent of cardiac events may be prevented with education and lifestyle changes.

February 2 is National Wear Red Day. The American Heart Association teams up with Support Go Red For Women to help support programs that generate awareness and research to discover knowledge about cardiovascular health. To donate, click here.

February 22 is the 2nd annual Heart Valve Disease Awareness Day. According to the Alliance for Aging Research, “The goal of the National Heart Valve Disease Awareness Day is to increase recognition of the specific risks and symptoms of heart valve disease, improve detection and treatment, and ultimately save lives. While heart valve disease can be can be disabling and deadly, available treatments can save lives, making education and awareness particularly important.” To learn more, visit

Looking to take charge of your heart health? Don’t ignore the symptoms any longer and seek treatment.  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..



High blood pressure is not good for your body. Chronic high blood pressure can lead to serious health conditions, including hypertensive heart disease. Hypertensive heart disease is the number one cause of death associated with high blood pressure. It’s important to monitor your blood pressure to ensure it’s in a healthy range, so you don’t run the risk of developing left ventricular hypertrophy, ischemic heart disease, or heart failure.

Unfortunately, many people don’t even realize they’re living with high blood pressure. It is often referred to as the “silent killer” because it has no obvious symptoms. High blood pressure usually develops slowly over time; it cannot be cured, but it can be managed through lifestyle changes and medication.

Although most people don’t experience symptoms with high blood pressure, some people do have episodes of shortness of breath, dizziness, blurred vision, and headaches. However, there has been debate regarding whether or not high blood pressure and headaches actually are related. Overall, there doesn’t appear to be an association between headaches and high blood pressure. Sometimes, extremely high blood pressure can lead to a headache, but it’s not easy to determine if less extreme cases do.  Patients with headaches can develop high blood pressure due to the pain and stress of the headache, but in these cases the blood pressure usually returns to baseline levels after the headache goes away.

Pheochromocytomas, which are rare tumors, can cause headaches and high blood pressure. The headaches from this tumor are usually accompanied by palpitations, sweating and anxiety. These symptoms, and the high blood pressure, are due to the tumor producing hormones and biochemical substances.

Moderate (140s) and severe (160s) levels of high blood pressure are usually not associated with headaches, but a danger level (180s and above) can be.

There are several reasons why you can be experiencing headaches or high blood pressure, and you should not ignore any painful or worrisome symptoms. Make an appointment with your doctor to discuss and evaluate your symptoms.

If you suffer from heart valve disease and need surgery to correct a valve, it’s time to talk to a mitral heart valve surgeon about your options. Dr. Peter Mikhail is a heart valve surgeon who performs mitral valve surgery, TAVR and mini-AVR. 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.


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.


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.



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.


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.


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.



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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