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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.


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.


About two months ago, Dr. Mikhail began performing TAVR at his New Port Richey, FL location. For those of you suffering from aortic valve disease, we would like to share with you some basic information on this surgical procedure. TAVR stands for Transcatheter Aortic Valve Replacement and it is considered a revolutionary, and still relatively new, heart valve treatment. TAVR is an alternative to open-heart surgery, which means it is minimally invasive. This surgery is performed through a small catheter.

This procedure is recognized as a big advancement in modern medicine since open-heart surgery was developed in the 1950s. In the last several decades, many patients, especially the elderly, were unable to undergo open-heart surgery for their aortic valve disease because the surgery had too many risks. Because they were unable to receive the surgery, these patients would unfortunately end up dying from the disease. With TAVR, patients do not need a sternotomy (chest cracked open) and do not need to be placed on a heart-lung machine. TAVR isn’t considered such a high-risk operation, so more people are able to receive this treatment.

In TAVR, the doctor will insert a catheter in the leg or chest and guide it to the heart. The replacement aortic valve is inserted through the catheter into the heart. If the valve isn’t expanding on its own, a balloon is often used to expand the valve. After the valve is implanted, the doctor removes the catheter from the blood vessel. With TAVR, there are three different approaches. The doctor will decide which TAVR approach is a good match for you. The approaches are:

  1. Transfemoral Approach – This is done through an incision in the leg.
  2. Transapical Approach – This is done through an incision in the chest between the ribs.
  3. Transaortic Approach – This is done through an incision in the upper chest.


Since TAVR is still a new procedure, it is recommended mainly for those suffering from severe aortic valve disease but who are at high risk if undergoing open heart surgery. A cardiologist, cardiac surgeon and imaging specialist will determine if a patient is in the high-risk category and eligible for this type of surgery. Some factors that make a patient high risk include older age, previous heart surgeries, lung disease, and kidney disease.

TAVR is considered a relatively safe surgery, but as with any surgery it comes with risks, including death, stroke, valve leaks, kidney failure and vessel damage. These complications are rare, and as TAVR becomes more widely used, the complications continue to decrease.

TAVR patients, for the most part, leave the hospital within a week following the surgery. Many patients will be placed on a blood thinner following the procedure.

If you suffer from aortic valve disease and think you may be eligible for TAVR or want to know more about this surgery, call Dr. Mikhail’s office at 727-312-4844 or click here to book an appointment. Dr. Mikhail is a cardiac surgeon who treats patients with aortic valve disease in the New Port Richey, Tampa, and Clearwater areas.


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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