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Marijuana is no longer illegal everywhere, as many states have legalized its usage for both medicinal and recreational purposes. It is a commonly used drug. In recent years, more reports have emerged about marijuana’s cardiovascular side effects. These side effects may be uncommon, but they can still be potentially harmful.

Some studies and theories state that marijuana slows down the blood flow in the coronary arteries. One study showed a patient passing out after marijuana usage; this patient developed dangerous heart rhythms from the reduction of blood flow in the coronary arteries. After the marijuana was out of the system, the flow reverted to normal, as well as the heart rhythm. In another case, the slow coronary blood flow due to marijuana usage led to a major heart attack.

The body’s heart rate and blood pressure increase within minutes of using marijuana despite people saying the drug has relaxing effects. Statistically, people who use marijuana are more likely to use other illegal drugs, more likely to smoke, and have a poorer diet, which are all risk factors for heart disease.

One of the more common side effects of marijuana usage reported is an irregular heart beat (atrial fibrillation). Usually, the afib occurred right after inhaling. Often, afib can occur without the person even knowing. Usually, there was no recurrence once the marijuana usage stopped.

In one study, the risk of heart attack increased 5 times the average after one hour after using the drug. Other reports have found this same finding.
It can be hard to target marijuana as the sole reason a person is experiencing heart problems, because often the person is also a smoker or uses other drugs, so to put the blame solely on marijuana would be false. As more studies and reports study marijuana’s relation to heart disease and other heart problems, we will be able to see if there is a correlation, and if marijuana causes harmful side effects to the heart. Despite there not being many studies proving one way or another if the drug’s effect on the heart is bad, it is still good to keep in mind that the drug may have some harmful effects.

If you experience afib or any other issues with your heart, it’s time to get them checked out. If you suffer from heart valve disease and need surgery to repair or replace a valve, it’s time to talk to a 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.


February has just past, and whether you’re in a relationship or not, you may have had your share of Valentine’s Day candies. Who can resist the heart-shaped chocolates in the store? Since you may have consumed an excess amount of chocolate, you may be wondering, “Is chocolate even good for me? And my heart?” The good news: it is! However, you should be eating it in moderation. Too much of anything can be bad for the body.

Chocolate has positive benefits on the body. How? It can help promote better blood flow, lower blood pressure and improve some cardiac conditions. A few years ago, researchers from Boston to Birmingham conducted a trial and found that chocolate helps the heart because of the flavonoids it contains. Studies have showed people with higher weekly consumption of chocolate had the lowest risk for heart disease, but if you replaced that chocolate with candies (non-chocolate) they could actually double their heart disease risk.

Flavonoids are a nutritional subset of polyphenols, which help lower incidences of coronary heart disease and stroke. The highest flavonoid amount is found in dark chocolate.

According to the dean of the Friedman School of Nutrition Science and Policy at Tufts University, polyphenols help to improve the health of the blood vessels.  In one study, people who consumed 16-100 grams of chocolate per day benefitted the most from consumption.

Dark chocolate isn’t the answer to all your heart problems though! Eating chocolate all day will not make you the healthiest person. You still need to consume a heart-healthy diet full of protein, healthy fats, whole grains, fruits, and vegetables.

So, enjoy a piece or two of that left-over Valentine’s candy!

If you have a history of heart disease in your family or currently suffer from heart disease, it’s time to talk to your doctor about the best heart-healthy diet for your specific needs.  If you suffer from heart disease and potentially need surgery, it’s time to talk to a heart valve surgeon. 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.


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.


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.


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.


If you have been diagnosed with mitral valve disease, you probably have a list of questions. As you should! Mitral valve disease is one form of heart disease, and it can be a very serious condition. Part of your heart valve isn’t working properly, and it’s you and your doctor’s job to decide what to do next so you can live a healthy and long life.

There are three different types of mitral valve disease: mitral valve regurgitation/insufficiency (leaking), mitral valve stenosis (obstruction), and mitral valve prolapse (bulging).

The type of mitral valve disease you have and the severity of it will determine your doctor’s treatment plan. One treatment option is surgery. But when is it time to repair your mitral valve? Is there a good time? Well, if you have a severe case or a big leak, it’s recommended you get the valve repaired now. If you put off surgery, the damaged valve will begin to cause damage to the heart itself. Valves cannot repair themselves; there is no point in waiting. Studies have shown if you wait for symptoms to become severe before you choose surgery, your chance of experiencing complications after the surgery is higher.

If the valve is severely damaged, a surgeon may not be able to repair the valve and a replacement will have to be done. If your valve disease is life-threatening, a replacement valve will be chosen over a repair.

Treatment isn’t always needed for minor causes of mitral valve disease. Sometimes the doctor will just monitor a patient’s heart over the years to see if the disease is getting progressively worse. The doctor can also prescribe medications to reduce the symptoms that patients are experiencing from the disease, but the medications cannot fix the broken parts of the mitral valve. Patients can take antiarrhythmics, beta blockers, diuretics, and anticoagulants.

The thought of surgery can be terrifying; there may be no “right” time, but you want to fix the problem before it gets worse. Dr. Peter Mikhail performs minimally-invasive mitral valve heart surgery on his patients. He makes a small (2 to 3 inch) incision in the right side of the chest. This is not open-heart surgery. With minimally invasive surgery, recovery is shorter. Surgery can take anywhere from 2 to 4 hours.

If it’s time for you to get your mitral valve repaired or replaced, let Dr. Mikhail look at your heart and determine the best course of action. He is a cardiac and thoracic surgeon who specializes in mitral valve surgery. He treats patients in the New Port Richey, Tampa and Clearwater areas of Florida. To book a consult, click here or call 727-312-4844.  Learn more about this surgery on Dr. Mikhail’s Mitral Valve Surgery page.




Are you a candidate for mitral valve surgery? If so, you probably have a lot of questions. Although surgery on the mitral valve can be minimally-invasive these days, it can still be scary going under the knife for a heart operation. Dr. Peter Mikhail is a cardiac and thoracic surgeon who specializes in treating and operating on patients with mitral valve disease. Below, we share some answers to a few questions you may have if you’re deciding to have this surgery.

Do I need my mitral valve repaired or replaced?
Dr. Peter Mikhail will assess the damage to your valve to determine if he is able to repair the valve or if it’s better to replace it. Through his years of experience, Dr. Mikhail can make an educated, experienced decision on which is the best option for you.

Should I choose a mechanical valve or a biological valve?
This is a decision that will be made between you and the doctor. The doctor will look at your history, symptoms, age, and lifestyle to determine which type is better for your body. Mechanical valves require a person be on blood thinners for the rest of his or her life, so a younger, active person may not choose this option. However, mechanical valves do last longer and don’t succumb to wear and tear like a biological valve would. A biological valve will have to be replaced in 10 years or so; this is something a younger patient will need to consider. Again, this is a decision between you and the surgeon.

What tests do I need before this surgery?
You will have an echocardiogram and/or stress test done to determine if surgery is the right course of action.

How long is mitral valve surgery?

The operation itself takes around 45 minutes, but the entire process (prep, closing, etc.) can take up to four hours.

How long am I in the hospital after this surgery?
After surgery, you will spend one to two days in ICU. After ICU, you will be moved to a regular hospital room for several days. The doctor and other medical professionals will monitor your recovery, vitals, and pain. Recovery can take one to three months.

For more FAQ, click here.

To book a consult with Dr. Peter Mikhail, click here or call 727-312-4844.  Dr. Mikhail specializes in mitral valve surgery and works out of the Tampa, Clearwater, and New Port Richey areas in Florida.


Whether you have suffered a heart attack or stroke, or have been told by your doctor that you are at an increased risk of heart issues, chances are you have been looking seriously into ways to change your lifestyle. Nothing prompts healthy lifestyle changes like a scare, but we don’t have to wait until we have a heart attack to find out we are at high risk before we take our lives into our own proverbial hands and make some healthy changes for the better.

For most of us, diet and exercise are the two areas where lifestyle and personal change can make a significant difference in our heart health and resulting risk factors. While it might be nice to think that medication alone is all that we need, effort on our part to make better, more healthy choices, is part and parcel to being healthy and to reduce the risk for issues or recurring issues.

Diet is an area where almost all of us fail to meet the recommended goals. For whatever reason, most of us eat a diet rich in fattening, oversized portions of convenience foods that are high in calories and low in nutrition. While we do not have to resort to a life without cheeseburgers, we do have to make changes in what, how much, and how often we eat.

There are some simple rules of thumb for keeping your diet under control and changing your diet in more heart-healthy ways. First and foremost, watch the portion sizes. Most of us are shocked when we look a bit deeper and find out just how small a serving size truly is compared with the amount we serve ourselves. Using smaller plates gives you the illusion of eating more and can really help with portion control. Secondly, watch out for liquid calories. A lot of people don’t realize just how many calories they consume with their daily coffee drinks, soda, wine, beer, and juice. Switching out some of these sugar-laden drinks for water or unsweetened tea is a great heart-healthy choice.

When it comes to eating more heart healthy, there are some general tips that will make all dietary choices a bit easier. If we are mindful of the portion sizes we are eating and work to reducing the amount of food we eat to healthier levels, we can really reduce the amount of fat, calories, and artery-clogging foods we consume. Also, by making more cognizant beverage choices, we can reduce the amount of unnecessary sugar and calories we consume in liquid form. These small changes will reduce the amount of fat, sugar, and junk in our diet, promoting more healthy choices.

If you’re currently suffering from heart valve disease and considering surgery, contact Dr. Peter Mikhail. Dr. Mikhail is a cardiac surgeon based in New Port Richey, Florida. To book an appointment, 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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