aortic valve disease 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.

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.

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.

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.

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.

Today, we are going to discuss a treatment method for aortic stenosis and aortic regurgitation – two serious conditions that affect the heart’s aortic valve – called Mini-AVR.

First, let’s talk about what those conditions are.

Aortic stenosis occurs when the cusps of the aortic valve become abnormally rigid and do not fully open. This narrowing of the valve creates resistance against the pumping of blood from the left ventricle to the rest of the body, and if left untreated, it can lead to heart failure.

Typically, this condition is the result of degeneration due to natural aging and health issues and calcium buildup on the valve cusps over time causes them to stiffen.

Aortic regurgitation occurs when the aortic valve allows blood to leak back into the left ventricle. It’s often caused by valve damage due to a recent infection or rheumatic heart disease, or it’s a congenital heart defect you were born with.

The symptoms of both conditions include shortness of breath, chest pain or heaviness, fainting or lightheadedness, decreased physical endurance during exercise, and swelling of the limbs.

The severity of aortic stenosis and aortic regurgitation will determine treatment. A Minimally Invasive Aortic Valve Replacement, or Mini-AVR, involves the surgical replacement of the aortic valve with a prosthetic valve. Its benefits include less trauma and pain, better cosmetic results, a shorter recovery time, and a potentially lower financial cost.

During Mini-AVR surgery, a small incision is made in the upper chest area, and a cardiopulmonary bypass machine is used to take over functions of the heart and lungs, so that blood continues to flow around the heart and the body’s oxygen levels remain stable. A surgeon will open the aorta (and, if necessary, remove any diseased valve cusps), measure the valve ring, and insert the prosthetic valve.

The surgery typically takes about 2 to 3 hours. Several recent studies have shown that a Mini-AVR procedure is potentially safer than a conventional AVR procedure with a full sternotomy, which calls for much larger incision.

It’s important to talk to your doctor about the best treatment options for aortic valve conditions. In some cases, medication may be effective treatment for aortic regurgitation. However, receiving timely surgery is often advised because a significant delay could lead to congestive heart failure.

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.

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.

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Blood pressure and heart health go hand in hand. Your blood pressure reading reflects two numbers, systolic pressure and diastolic pressure. Your systolic pressure measures the pressure of the blood against your artery walls when the heart pumps blood out during a heartbeat, while your diastolic pressure measures this pressure in-between heartbeats when your heart is full of blood. Ideally, your blood pressure should read below 120/80. One in three American adults suffer from high blood pressure. One thing you can do to keep your blood pressure in check is to eat a balanced diet. Certain foods are known to increase your blood pressure. We suggest you avoid the following foods or limit them in your diet to keep your blood pressure in a good range:

Soda/sweetened beverages – Sugar-loaded drinks can quickly lead to weight gain; excessive weight on the body can raise a person’s blood pressure.
Processed meats and other foods – Deli meats like turkey or ham are loaded with sodium, which can raise a person’s blood pressure. Lots of packaged foods contain high amounts of sodium, e.g. canned soup, frozen meals, tomato sauces, canned vegetables and bread. These foods have a lot of sodium, because this ingredient is used to preserve the foods.
Baked goods – Cakes, doughnuts, muffins, cupcakes, cookies, pies and more are loaded with sugar, but also contain a lot of saturated and trans fats. Both these “bad” fats are known to increase blood pressure.
Candy – When you eat a piece of candy, you’re basically consuming empty calories and a lot of sugar; candy can spike your sugar levels and can lead to weight gain.
Alcohol – Excessive use of alcohol can lead to weight gain and dehydration both of which can lead to an increase in blood pressure.

Each day, you should aim to keep your sodium intake to less than 2,300 milligrams; sugar should be limited to 37.5 grams per day for men and 25 grams per day for women. It’s best to avoid or limit the above foods and opt for water, 100 percent fruit juices, fresh meat, fruit, homemade (healthier) desserts, nuts, legumes, vegetables, and whole grains.

If you currently have high blood pressure or heart disease, it’s wise to discuss with your doctor the best meal plan for you. If you suffer from mitral valve disease or aortic valve disease and need surgery, Dr. Peter Mikhail is a cardiac surgeon treating patients in the Tampa, Clearwater and New Port Richey areas of Florida. To book an appointment, click here or call 727-312-4844.

Older Posts

MITRAL VALVE BLOG

Facts About Aortic Stenosis

What to Expect Post Heart Valve Surgery

Why is My Valve Calcifying?

What is TAVR?

What is infective endocarditis?

What is Mini-AVR?

Consumer tech: Top heart rate monitors of 2017

The benefits of exercise on heart health

Changes to Make to Prevent Heart Disease

Food to Avoid in Your Diet to Keep Your Blood Pressure in Check

Time in the Sauna Can Benefit the Heart

Aortic Stenosis 101

What is Structural Heart Disease?

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