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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.




Heart disease is the Number One killer in America. Some people are born with heart disease. Some people have a buildup of fatty plaque in their arteries due to lack of exercise, smoking or an unhealthy diet. Some people develop heart issues from drug habits or stress.  Some people develop heart disease from high blood pressure. Some people have heart issues from trauma or infection. As you can see, there are many ways a person can develop heart disease, which means it’s in your best interest to do everything within your power to ward off the disease.

No one lives a perfect life. No one has the ideal diet. People skip workouts. People don’t sleep enough. Accidents happen.  But we can help ourselves by trying to lead the healthiest lives possible to keep our hearts strong so we can live longer, happier lives.

Making a lifestyle change for better heart health can be overwhelming for some, so we want to share with you some real, basic tips on everyday things you can do to improve your heart health and lower your risk of heart disease.

  • If you have to lose a lot of weight, don’t stress. Set your weight loss goals at small increments. Aim for 5 pounds, then aim for another 5 pounds. It’ll add up quickly and these smaller increments will seem far more attainable than saying, “I need to drop 60 pounds.”
  • Incorporate more fresh fruit and vegetables in your diet. Your body needs a variety of different vitamins and minerals to function properly. Try to eat around 5 servings of fruit and veggies per day.
  • If you smoke, quit! It is easier said than done, but if you quit you lower your chance of developing heart disease or having a heart attack by 50 percent!
  • Aim for 7 to 9 hours of sleep per night. Research has shown that proper rest reduces a person’s chance of developing heart disease.
  • Exercise keeps your heart healthy. 30 minutes of exercise a day is ideal to keep your heart in a heathy state. If 30 minutes is too much for you, you can split it into two 15-minute segments of exercise or three 10-minute segments throughout the day.
  • Stay hydrated! When your body and blood are well hydrated, the heart doesn’t have to work as hard to pump and keep the blood flowing.

Changing your lifestyle to promote better heart health doesn’t have to be a daunting, overwhelming task. Take it one step at a time! Slowly start incorporating the above list in your daily habits, and I bet you’ll start feeling better!

If you currently suffer from heart disease, including mitral valve disease or aortic valve disease, and are considering surgery, you should book a consult with Dr. Peter Mikhail. Dr. Mikhail is a cardiac and thoracic surgeon who performs mitral valve surgery and mini-AVR on patients with mitral valve or aortic valve disease. He treats patients in the Tampa, Clearwater and New Port Richey areas of Florida. To book an appointment, click here or call 727-312-4844.



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.


Did you know a painkiller, one that’s probably in your medicine cabinet right now, can increase your risk of heart disease? Scary thought, right? Well, over-the-counter NSAIDs (nonsteroidal anti-inflammatory drugs) have been proven to increase the risk of heart disease through heart attacks and strokes. Studies have shown a 20 to 50 percent increase in risk of heart attack when using NSAIDs compared to when not using them.

It’s best to take these types of medications in small doses and for a short time so they will not have serious effects on your heart. Don’t become a regular user.

Common NSAIDs you can find in your home include ibuprofen and naproxen, the most common being Advil, Motrin and Aleve. Aspirin is a type of NSAID but not does not increase your chances of having a heart attack or stroke.  All these over-the-counter NSAIDs are used to treat pain and inflammation in the body.

If you currently suffer from any heart condition, you should take NSAIDs with caution, and definitely talk to your doctor about taking them.  For people with heart conditions, NSAIDs can potentially make your conditions worse. You don’t have to stop taking NSAIDs, especially if you’re in a lot of pain, but be mindful of how, when, and why you’re taking them.

Even if you currently don’t have a heart condition, be cautious when taking NSAIDS. If you truly need to take one for pain relief, aim to take the smallest dosage, and not for an extended period.

Studies haven’t proven that NSAIDs cause heart attacks, but some research shows that NSAIDs can increase blood pressure or raise the risk of a blood clot, which can lead to a heart attack.

Even though these NSAIDs are over-the-counter medications, you should be careful with them in the same way you would be with a prescription-level painkiller. Medication is medication, and too much of any kind can do you harm.

If you have heart disease and need surgery on your valves, Dr. Peter Mikhail performs mitral valve surgery and aortic valve surgery in and around Tampa, Clearwater, and New Port Richey, Florida. To book a consult, click here or call 727-312-4844.


If you’re experiencing symptoms of heart disease, there’s a good chance you’ve gone to see your doctor. Chest pain, dizziness, and shortness of breath are all red flags that should send you to your doctor immediately. If a doctor hears anything alarming through a stethoscope, he or she will suggest you have some testing done to confirm if you have heart disease. You will also need to make an appointment with a cardiologist. One such test you will have to take is a stress test.

A stress test can help the doctors determine if you have heart disease.  One type of stress test, and the one most often used, is the exercise stress test.  During an exercise stress test, you will either walk on a treadmill or pedal a stationary bike. The doctor will use the test to track your electrocardiogram, heart rate and blood pressure.

What does this test do or show? An exercise stress test will show a few things to the doctor, including:

  • If enough blood is flowing to the heart during activity
  • If there are any abnormal heart rhythms
  • If the heart valves are functioning properly
  • If you have coronary heart disease
  • If your symptoms (chest pain, palpitations, dizziness) are being caused by a heart issue
  • If your heart medications are working (if you’re on any) and how

Before the test, you cannot eat or drink anything except water for four hours prior to the test, and cannot have caffeine for 12 hours before the test. There are also certain medications your doctor will tell you that you cannot take before the test, – your doctor will advise you.

Before you begin exercising on the test, an EKG will be done to take your heart rate at rest. After the EKG, you will begin exercising. The exercising will gradually get more difficult to get you exhausted. You will be asked throughout how you are feeling and if you’re experiencing any symptoms. The test lasts about 60 mins, but you’re only exercising around 10 minutes.

If you’re experiencing any of the symptoms mentioned above, it may be time to talk to your doctor and see if a stress test is a good idea. Depending on the test’s results, you’ll want to see a cardiologist. If you’re looking for a cardiac surgeon, Dr. Peter Mikhail specializes in mitral valve and aortic valve surgery. To book an appointment with him, click here or call 727-312-4844.



You’ve probably heard the term “statins” before. In case you haven’t, statins are a class of lipid-lowering/cholesterol-lowering medications. They are known to help reduce the risk of cardiovascular disease, chest pain, strokes, heart attacks, and death in people. For this article, we want to share a general overview of statins and heart disease and if a person should or should not be taking them. Ultimately, this is a conversation to be had with your primary care doctor or cardiologist. Every patient’s situation is different and should be handled differently.

Many studies have shown that statins have been able to keep people alive longer by reducing the risk and number of heart attacks and strokes a person will or may experience. Statins help in preventing the arteries from building plaque and becoming blocked. They inhibit the enzyme HMG-CoA reductase.

If you happen to have many of the risk factors of developing heart disease (and not just solely based on your age), a doctor may recommend this drug to you. The statins help reduce the chance of heart disease by preventing atherosclerosis, which is blocked arteries or narrowed blood vessels.

Like any drug, there are side effects and risks. Some side effects include: muscle aches and cramps, pins and needles feeling, bloating, diarrhea, rashes, stomach pain, cataracts, impaired memory, headaches, liver failure, skeletal muscles and diabetes.

If you suffer from heart disease or are at a high risk, your doctor may put you on a statin regardless of your cholesterol levels. On average if your risk is over 7.5 percent in the next 10 years, the doctor will likely prescribe a statin.

If you are a heart disease patient, it is time to discuss with your doctor if a statin is right for you. If medication is not an option, heart valve surgery may be recommended. Dr. Peter Mikhail of Tampa, Clearwater, and New Port Richey, Florida, performs mitral valve surgery and mini-AVR on patients with mitral valve disease and aortic valve disease. To book an appointment or learn more, click here or call 727-312-4844.



Heart disease is the leading cause of death in America. Each year, more than 600,000 people die from a form of this disease. Each year, more than 5 million Americans are diagnosed with heart valve disease. But, why? Why do so many people develop heart disease? When it comes to heart disease, there are a number of different risk factors that can lead a person to developing one of the many forms of heart disease. Below, we share with you some of the common risk factors associated with heart valve disease.

Genetics – Heart disease or abnormalities can commonly run in families, especially bicuspid aortic valve disease or mitral valve prolapse.

Age – As we get older, the heart valve ages as well. The flaps (leaflets) in the valves can thicken and harden as they get older which causes a restriction of blood flow. Men over 65 years old and women over 75 years old are at the highest risk for developing heart valve disease.

Heart attack – When a person has a heart attack, this can cause damage to the heart, and affect the function of the valves.

High blood pressure – If a person has perpetual high blood pressure, the heart works harder, so it becomes enlarged. The enlarged heart causes valves to stretch, which can keep the valves from closing correctly.

Cardiomyopathy – If the person has an enlarged heart, not only are the valves stretched, but the tissue ring around them also becomes stretched. If this does occur, leakage in the valves will happen.

Calcium deposits – Calcium deposits can start to build up in the mitral or aortic valves.

Rheumatic fever – Rheumatic fever can damage a person’s heart valves because it causes them to thicken so they no longer open and close properly.

If you fit one or more of these risk factors and are experiencing some symptoms, it may be time for you to contact a doctor. Dr. Peter Mikhail is a cardiac surgeon specializing in mitral valve surgery and mini-AVR. If you’re looking for a cardiac surgeon to perform your heart valve surgery, click here for more information or call 727-312-4844 to book an appointment with Dr. Mikhail.


Chest Pain. Shortness of breath. Dizziness. If you’re experiencing these symptoms, call your doctor immediately. There could be a chance that you have heart disease. At an appointment with your doctor, he or she will listen to your heart with a stethoscope and make the decision of whether you should be tested for heart disease. Stress tests are one way for doctors to determine if you have heart disease. If you are unable to walk on a treadmill or are on certain medications, the doctor will have you take a nuclear stress test instead of an exercise stress list.

A nuclear stress test will measure blood flow to your heart while at rest, and while your heart works hard from medication administered to you. From this test, a doctor will see images that will determine if you have low blood flow or any damage to the heart muscle itself.

Since you are unable to exercise, a radioactive dye will be administered into your bloodstream. This will speed up your heart rate to mimic exercise. Doctors will also suggest a nuclear stress test if you have coronary artery disease, or if an exercise stress test didn’t explain any of your negative symptoms.

During this test, a camera will see rays emitted from the dye in your body, which will create clear pictures of the heart and its tissue. The doctor will look at images while your heart is at rest, during and after exercise (elevated heart rate from dye). The test could take up to five hours as the blood needs to make its way through your body.

For a nuclear stress test, a patient cannot eat or drink or smoke for two hours prior. A doctor will determine on a case by case basis if you can or cannot take certain medications and consume caffeine before the test. Patients are asked to wear comfortable clothes and shoes.  After the test is done, the dye will leave your body through your urine or stool.

The results will determine the doctor’s next course of action. If the results show you have heart valve disease, there is a chance you will have to undergo heart valve surgery. If you’re looking for a cardiac surgeon, Dr. Peter Mikhail performs heart valve surgery, specializing in mitral valve surgery and mini-AVR. To learn more, click the heart valve surgery page. Click here to book an appointment with Dr. Mikhail or call 727-312-4844.


When one thinks of low testosterone, one usually thinks of low sex drive or sexual dysfunction. However, did you know that low testosterone and heart health are related? They can be. From 1970 to 2013, there were studies conducted on testosterone and causes of coronary artery disease, and a link was found between them.

How can this be? Well, the heart and its blood vessels have testosterone receptor sites within them, which means the hormone and heart work together. With a low testosterone level, a person can develop metabolic syndrome, which is a group of risks factors that can raise the risk of heart disease, diabetes and stroke. Such risk factors include: a large waistline, high triglycerides, a low HDL cholesterol level, high blood pressure, and a high-fasting blood sugar level.

A person can generally tell that he or she may have testosterone issues from the following symptoms: libido loss, fatigue, weight gain or loss, and depression. For men 50 and older, testosterone production drops 1 to 2 percent each year.

Studies in the Journal of the American Heart Association concluded that higher levels of testosterone go hand in hand with good heart health. They found that people with low testosterone often have abnormal EKG readings; they also found people with higher levels of this male hormone had a 25 percent less chance of suffering from sudden cardiac arrest.  These studies also found that when a man has low levels of testosterone he could also experience: insulin resistance, narrowed carotid arteries, congestive heart failure, higher incidences of angina, a higher risk of cardiovascular disease, extra fat around the mid-section with a high BMI level, type II diabetes, and a high death rate.

If you are over the age of 50 and experiencing any of the above symptoms, it’s best you contact your doctor to get your testosterone level checked. If you currently suffer from heart disease and are looking for a cardiac surgeon, contact Dr. Peter Mikhail, who works in the cities of Tampa, Clearwater, and New Port Richey, Florida. He specializes in mitral valve surgery and mini-AVR. Click here or call 727-312-4844 to book an appointment.




You’ve probably heard and read a thousand times about the best diets or foods to eat to be heart healthy; however, do you know the foods it’s best for you to avoid? Nutrition is an extremely important aspect to focus on when currently living with heart disease. Food can either act like a medicine or a poison based on your choices. You want to stay as healthy as possible while living with this disease before treatment, during treatment, and after treatment.

When your heart isn’t functioning at its best, it’s best to stay clear of certain foods to remain as healthy as possible.  Below are some foods you should think about limiting or avoiding if you’re currently suffering from heart disease.

Highly Processed/Refined Grains and Carbohydrates

Carbohydrates are great for your body; they supply the body with energy; however, when a carbohydrate is processed or refined, it loses most of its health benefits (fiber, fatty acids, vitamins and minerals). Processed foods usually come with added ingredients like sodium and trans fats. Some examples include: white bread, white rice, instant oatmeal, and some cereals.

Processed/Refined Sugars

Sugar, in moderation, won’t harm you, but if you consume enough of it, it can harm your heart by raising blood pressure and triglycerides. High dosages of sugar can be found in soda, some cereals, candy, baked goods, canned foods, and juice.

Certain Fats

Trans fats and saturated fats are not the “good” kind of fat. These types of fat can raise bad cholesterol and lower good cholesterol and contribute to clogged arteries. Foods known for their high trans fats and saturated fats include: fried food, margarine, doughnuts, biscuits, cakes, and pies.

High Sodium

Your body needs sodium. It helps keep your blood pressure in check, as well as maintain proper fluid levels in the body. If you consume too much sodium, your kidneys cannot process it all so the remaining sodium can elevate your blood pressure. Too much sodium can put a person at risk for heart failure, a heart attack, kidney failure or a stroke. Foods with high sodium include: canned soups, processed meats, fast food, salted nuts, canned vegetables, frozen meals.

Overall, it’s best to practice moderation in all things, especially in your diet if you are currently suffering from heart disease. One slice of pie at the holidays won’t harm you, but it’s best to avoid the above-mentioned foods with your heart in a fragile state.

If you’re in need of a great surgeon to perform mitral valve surgery or mini-AVR, Dr. Peter Mikhail is a cardiac surgeon in New Port Richey, Florida, who specializes in these surgeries. To book a consult or for more information, 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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