clearwater tavr Archives - Dr. Peter Mikhail

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.

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:

Transfemoral Approach – This is done through an incision in the leg.
Transapical Approach – This is done through an incision in the chest between the ribs.
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.

Keeping tabs on your health in today’s digital age is easier than ever before. But did you know that when it comes to monitoring your heart rate, a wrist-worn device isn’t as effective as one that’s strapped to your chest?

PC Magazine recently offered a review of 10 wearable heart monitors, and four out of the top five personal devices used chest straps to record heart activity. The magazine noted that chest-strap models, which use an electrical pulse to measure heart rate, are more accurate than wrist-worn devices that employ optical technology.

That finding is backed by a March 2017 report by the Cleveland Clinic, which tested five wrist-worn fitness trackers and came to the same conclusion – that monitors worn across the chest are more accurate at measuring heart rate while exercising.

Heart monitoring during sustained physical activity is especially important for individuals with heart murmurs and mild-to-moderate mitral valve regurgitation (MVR).

Here’s a list of the top chest-worn models (prices may vary):

—Wahoo Fitness Tickr X Heart Rate Monitor: “The Wahoo Fitness Tickr X is the best heart rate strap you can buy. It’s so much more than just a heart rate monitor, and yet it costs the same as other excellent chest straps that don’t offer nearly as much. It doubles as a run tracker. You can use it with or without your phone.”

$99.99 MSRP; $79 at Amazon.com (http://amzn.to/2wCvvb1)

—Polar H7 Heart Rate Sensor: “Polar users in need of an accurate HRM can’t go wrong with the H7, but it’s also good for anyone looking to add heart rate data to their run-tracking using one of the five supported apps. And if it works with your home or gym fitness equipment, all the better. The price is right, too. The Polar H7 is one of the most versatile and accurate HRMs available.”

$79.95 MSRP; $62.99 at Amazon.com (http://amzn.to/2gD39nJ)

—Polar H10 Heart Rate Sensor: “If your current H7 chest strap is showing some wear and tear, you might want to think about upgrading to the H10. The extended battery life and built-in memory make it a solid investment, especially if you have or are thinking of getting a Polar fitness tracker.”

$89.95 MSRP; $89.95 at Amazon.com (http://amzn.to/2wCXrvr)

—Garmin HRM-Run: “For runners who want a plethora of data, the Garmin HRM-Run gives you advanced stats including cadence, oscillation, ground contact time, ground contact balance, stride length, and vertical ratio. It makes for a pricey bundle when paired with a compatible tracker, but one worth considering.”

$99.95 MSRP; $83.74 at Amazon.com (http://amzn.to/2w3jkAu)

Dr. Peter Mikhail is a cardiac and thoracic surgeon based in New Port Richey, Florida, who treats patients in the Tampa and Clearwater areas. For more information on his practice or to schedule a consultation, visit Dr. Mikhail’s Mitral Valve and Aortic Valve website or call 727-312-4844.

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We all know that exercise and physical health go hand-in-hand. But did you know that exercising can help prevent heart disease and stroke, and even help individuals with some minor heart conditions?

The American Heart Association recommends getting at least 150 minutes per week of moderate exercise — or 75 minutes per week of vigorous exercise — to improve overall cardiovascular health. For individuals looking to lower their blood pressure or cholesterol levels, the organization recommends 40 minutes of moderate-to-vigorous aerobic exercise three to four times per week.

Aerobic exercises include walking, jogging, swimming, or biking.

Your heart is a muscle, and it gets stronger and healthier if you lead an active lifestyle. The resting heart rate of a person who stays active is slower than a non-active person, because less effort is needed to keep blood pumping. People who don’t exercise are twice as likely to develop heart disease compared to those who stay active.

Exercise promotes weight maintenance and reduction, and can reduce “bad” LDL cholesterol levels in the blood. Those “bad” lipoproteins lead to plaque buildup in the arteries, which narrows vital pathways for blood flow and raises the risk of heart attack and stroke.

Some cardiologists recommend combining short bursts of high-intensity exercise with slightly longer periods of recovery, so that the body becomes more efficient at clearing fat and sugar from the blood. Weight training can also help with heart protection for healthy individuals.

It’s been shown that exercise decreases symptoms of angina and heart failure, and even overweight people who have trouble shedding pounds can still achieve heart benefits with routine physical activity.

Experts also agree that the worst kind of exercise for heart health is “overdoing it” with vigorous physical activity without prior training, such as shoveling snow. The excessive adrenaline that is released throughout the body can lead to a sudden heart attack.

For people with mild-to-moderate mitral valve regurgitation (MVR) without symptoms, regular activity – even if it’s walking – will help heart functions. Using a treadmill with a digital heart monitor is one of the easiest ways to work out while keeping tabs on your pulse.

It’s important to note that people with MVR who are experiencing irregular heart rhythms should be cautious about physical activity, avoid a high-intensity workout, and consult their doctors about what type of exercise is appropriate.

Dr. Peter Mikhail is a cardiac and thoracic surgeon based in New Port Richey, Florida, who treats patients in the Tampa and Clearwater areas. For more information on his practice or to schedule a consultation, visit our Mitral Valve contact page or call 727-312-4844.

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