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MITRAL VALVE BLOG

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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.


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Heart disease is the leading cause of death in the United States. Fortunately, people can lower their risk of developing heart disease by monitoring their diets. Overall, a diet low in saturated fats and low cholesterol, along with many other dietary factors, help lower one’s risk. Over the years, there have been many studies and articles have been written on “heart-healthy” foods for people to add in their diets. These foods are known to have anti-inflammatory properties, lower bad cholesterol, lower blood pressure, have antioxidants, and raise good cholesterol – all of which can help ward off heart disease. Throughout the years, soy products have been cited as a food source that lowers blood cholesterol levels and help provide other cardiovascular benefits. However, this has now changed.

In November, the FDA announced to revoke an authorized health claim about soy and heart disease. For the first time ever, the FDA is proposing a revocation. Back in 1999, the FDA approved the claim (to be used on packaged soy products) that soy protein can help reduce heart disease. Now, they’re changing their tune.

The Director of the FDA’s Center for Food Safety and Applied Nutrition, Susan Mayne, said in a released statement, “While some evidence continues to suggest a relationship between soy protein and a reduced risk of heart disease—including evidence reviewed by the FDA when the claim was authorized—the totality of currently available scientific evidence calls into question the certainty of this relationship.”

Apparently, after the FDA approved this health claim in 1999, there have been inconsistent findings regarding the ability of soy protein to help lower LDL (“bad”) cholesterol. Now, this doesn’t mean soy consumption increases a person’s heart disease risk, it just doesn’t reduce it.

This soy claim may change from an “authorized health claim” to a “qualified health claim.” A qualified health claim requires a lower scientific standard of evidence to explain the limited (but not definite) evidence linking soy protein intake with heart disease risk reduction.

The FDA will go through a full, official revocation process that will allow the public and industry stakeholders a chance to submit comments to the FDA to persuade it to keep the authorization. People can comment until January 18, 2018.

If you’re looking for heart-healthy foods that can help reduce one’s risk of developing heart disease, choose foods like nuts, salmon, berries, oatmeal, avocado, spinach, tuna, and olive oil.

If you are suffering from heart valve disease, Dr. Peter Mikhail is a thoracic and cardiac surgeon in New Port Richey, Florida who performs mitral valve surgery and TAVR.  He also treats patients in the Tampa and Clearwater areas. Dr. Mikhail advises his patients on the best diets based on their condition. To book a consult with Dr. Mikhail, click here or call his office at 727-312-4844.

 


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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.


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Your doctor just told you that you have a calcified heart valve. One of your heart valves is stenotic. You potentially may need it repaired, or completely replaced. What does this exactly mean? How is there calcium build up on my valve? What is a stenotic valve? Is surgery the only option?

Upon being diagnosed with a type of heart valve disease, a lot of questions are probably buzzing around in your head – as they should be. Remember, never hold back from asking your doctor questions. You have just been diagnosed with mitral valve stenosis, which can be a very serious condition if left untreated. So, you should feel the need to ask and learn everything about this disease.

For this article, we address heart valve calcification/mitral valve stenosis to give you an overview of this disease. First, mitral valve disease is when the mitral valve (located between the left atrium and left ventricle heart chambers) is no longer working properly. When the valve isn’t functioning properly, the heart is unable to pump enough blood out of the left ventricular chamber to give the body oxygen-filled blood.  There are different types of mitral valve disease, but for this article, we will focus on mitral valve stenosis (obstruction).

Mitral valve stenosis is when the valve’s opening has narrowed and the valve’s flaps have thickened or stiffened; the flaps may have even fused together, which causes the narrowing or blockage of the valve. When this occurs, blood backs up in the left atrium of the heart instead of flowing to the left ventricle.

When the heart valve becomes calcified, there is a large amount of calcium on the valve, and it has been building up for many years. When the valve becomes calcified, the flaps become stiff and the valve narrows and becomes stenotic. How does this happen? Well, there are a few reasons. Some people’s valves begin to calcify just from age and wear and tear of the valves. Some people are born with congenital valve abnormalities. Some people’s lifestyle choices and history (smoking, chronic kidney disease, diabetes, elevated cholesterol) can lead to calcified valves. Some people’s valves become calcified through atherosclerosis, which is a process that causes arterial blockages in different parts of the body.

A person who has severe stenosis and calcification will experience shortness of breath, chest pain and lightheadedness.

With moderate to severe cases, surgery (valve repair or valve replacement) is usually suggested as the best option to fix the valve and eliminate symptoms. Patients can choose with their doctor whether they want a mechanical or biological heart valve. It’s good to note that even if you get your heart valve repaired or replaced, a biological valve can calcify again.

Unfortunately, there Is no known way to truly prevent the valves from calcifying. However, if a person does have a calcified valve, he or she should be under the watch of a cardiologist, to assess if the valve worsens over time. The cardiologist will most likely want to follow up in 6 months to a year. Treatment, such as surgery, will be suggested when deemed necessary.

Are you suffering from valve stenosis or calcification and looking for a surgeon? Dr. Peter Mikhail is a cardiac surgeon who specializes in performing surgeries on mitral and aortic valves. Dr. Mikhail is based in New Port Richey, FL, and treats patients in the Tampa and Clearwater areas. To book a consult, click here or call 727-312-4844.


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Infective endocarditis (also known as IE) is an inflammatory condition that affects the inner lining and valves of the heart. It occurs when bacteria enter the bloodstream and settle on damaged heart tissue, weak or abnormal heart valves, or prosthetic valves.

IE is more prevalent among older Americans and men in particular. It affects an estimated four out of every 100,000 people in the U.S., and the number of reported cases appears to be increasing, according to a 10-year study published by the online journal PLOS ONE.

It’s not uncommon for bacteria to enter the bloodstream during certain surgical, routine medical, or dental procedures, and a healthy immune system will fight off the microscopic invaders. However, if they find their way to the heart, those bacteria can accumulate on a damaged heart valve and grow into a mass known as a “vegetation.”

Symptoms of an acute infection, which can become life threatening in a matter of days, include a sudden high fever, increased heart rate, shortness of breath, and fatigue. A sub-acute, or gradual infection will present itself with a mild fever, elevated heart rate, fatigue, chills and night sweats, and a low red blood cell count.

Individuals with heart disease and existing heart conditions – such as surgically repaired heart valves and congenital heart defects – have a higher risk of developing IE.

Infection in the heart is commonly detected with an echocardiogram.  A blood culture can determine what type of bacteria is present. Treatment typically involves the use of intravenous antibiotics over a four-to-six-week span.

Oftentimes, doctors will prescribe oral antibiotics to patients prior to a dental procedure, minor surgery, or a colonoscopy as a precautionary measure.

Gingivitis is a known cause of infection, so keeping your mouth clean and healthy, and getting regular dental care are two simple ways to prevent IE. The American Heart Association offers wallet cards in English and Spanish for people who require extra protection from infection.

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 his mitral valve surgery and AVR site for more information or call 727-312-4844.


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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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