aortic valve surgery 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.

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.

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.
Choose a cardiac surgeon with a specialty in mitral valves and aortic valves.
Look for a cardiac surgeon who performs more than 20 mitral valve or aortic valve surgeries throughout the year.
Look at pictures and testimonials of your doctor’s past patients. Specifically, look at patients’ stories who are like yours.
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.
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.
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.

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.

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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Get up, and get moving! Exercise is essential to heart health. However, you don’t have to be overly athletic or a marathon runner to reap the benefits of exercise. According to the American Heart Association, a person can improve his or her overall cardiovascular health by participating in at least 150 minutes of moderate exercise or 75 minutes of vigorous exercise (or a combination of both) per week. Exercise comes in many different forms, from running and lifting weights to Zumba class and walking. For this article, we focus on the benefits from one particular type of exercise, Yoga.

Yes, yoga. This form of exercise is much more than a bunch of funny-looking body positions. People have been practicing yoga for more than 5,000 years to help rejuvenate the body and help themselves live a longer life. Yoga has been shown to have numerous benefits including helping reduce stress and bring clarity and peace to a person’s mind. Recently, a new study published in the European Journal of Preventative Cardiology said that yoga may help lower a person’s risk for heart disease in the same way as walking or another conventional exercise.

In this study, people of all ages and health conditions saw improvements in their health while participating in yoga. These people lost weight, lowered their blood pressure, and lowered their LDL (“bad”) cholesterol levels.

Yoga is physical but it also involves a lot of breathing exercises and meditation. These activities can all have positive effects on the heart and body. Yoga’s impact on muscles and the mind can help control blood sugar, lower blood pressure, and calm the nervous system, which can reduce stress in the body. Yoga can also help increase a person’s aerobic capacity, and has also been known to help people with atrial fibrillation have fewer episodes.

Yoga classes are available for people of all experience levels. If you have a health condition or aren’t in great shape, a beginner class is a great way to learn all the moves in a slow, controlled way that isn’t intimidating. Hatha yoga is good for beginners, while Vinyasa yoga is better for those individuals who are more experienced and physically fit. Bikram yoga or Hot yoga, which is yoga in a room with a temperature of more than 105 degrees, is not recommended for people with heart conditions like heart disease.

If you currently have heart disease, talk to your doctor about taking a yoga class. If you’re a candidate for heart valve surgery, Dr. Peter Mikhail performs mitral valve surgery and aortic valve surgery in the cities of Tampa, Clearwater, and New Port Richey of Florida. To book a consult, click here or call 727-312-4844.

Good fats are good for your heart. Unfortunately, the word “fat” comes with a negative connation in today’s society. When someone hears a food has “fat” in it, he or she assumes the food is “bad,” which isn’t always the case. There are different types of fats in the food we eat. For this blog article, we will focus on the “good” fats, which are known as monounsaturated and polyunsaturated fats.

Monounsaturated and polyunsaturated fats are known to lower bad cholesterol levels, lower risk of heart disease, lower risk of stroke, and can also provide the body with the proper, essential fats it needs to function that the body cannot produce on its own.

In fact, consuming healthy fats in your daily diet can potentially give your body the same health benefits as taking a statin drug, according to the American Heart Association. A statin drug is a lipid-lowering medication, which can help reduce people’s risk of heart disease, other cardiovascular conditions, and death.

According to the American Heart Association, polyunsaturated fats can help lower a person’s heart disease risk the best, with monounsaturated fats coming in at second.

Here is a list of some great sources of polyunsaturated and monounsaturated fats:

Sunflower oil
Safflower oil
Olive oil
Peanut oil
Avocados
Flaxseed
Sunflower seeds
Walnuts
Tuna
Salmon
Sardines
Trout

Diet is extremely important to a person’s heart health. According to the American Heart Association, if a person decreases the amount of saturated fat (“bad” fat) he or she consumes, and increases the polyunsaturated and monounsaturated fat intake, he or she can help prevent diseases from forming in the heart and blood vessels. Saturated fat is known to increase LDL (“bad”) cholesterol levels, which can lead to clogged arteries and cardiovascular disease. Overall, the American Heart Association recommends consuming mostly monounsaturated and polyunsaturated fats, while limiting saturated and trans fats.

If you’ve been diagnosed with heart disease, it’s still in your best interest to consume a healthy diet, rich in vitamins, minerals, and healthy fats. You want to keep your heart as healthy as possible. If you’re looking for a cardiac surgeon to treat your condition, Dr. Peter Mikhail specializes in treating patients with mitral valve disease and aortic valve disease. He works in the cities of Tampa, Clearwater and New Port Richey in Florida. To book a consult with Dr. Mikhail, click here or call 727-312-4844.

In America, heart disease is the leading cause of death for both men and women. Because of this startling fact, we want to share some statistics and facts about heart disease with you so you can be better informed on this serious condition.

One in four deaths in America is from heart disease. This means around 715,000 people die each year from this disease. In 2011, 787,000 people died from this condition.
The most common type of heart disease is coronary heart disease (CHD); CHD kills more than 370,000 people each year.
Around 735,000 Americans each year have a heart attack. In the United States, someone has a heart attack every 42 seconds.
Someone in America dies every minute from something related to heart disease.
High blood pressure, high cholesterol, and smoking are the top three key risk factors that can lead to heart disease.
Obesity, excess weight, excessive use of alcohol, poor diet, diabetes, and inactivity are also risk factors of heart disease.
Heart disease costs America around $207 billion every year.
Even if you don’t have any symptoms, you can still be at risk and/or have heart disease.
By the year 2030, around 23.6 billion will have died from a type of heart disease around the world.
80 percent of heart attacks and strokes can be avoided by not smoking, being active, eating healthy, and maintaining healthy blood pressure and sugar levels.
Cardiovascular diseases kill more people than all forms of cancer combined.
In the last 30 years, more women have died from heart disease than men.
15 percent of people who have a heart attack will die from the episode.
France, Australia, Switzerland, Japan and Israel have the lowest rates of heart disease deaths while Russia, Bulgaria, Romania, Hungary, and Argentina have the highest rates.
In the USA, states that have the highest rate of heart disease deaths include: Oklahoma, Louisiana, Mississippi, Alabama, Arkansas, Missouri, Tennessee, Kentucky, West Virginia, Maryland, Ohio and Michigan.

If you currently suffer from heart disease or have a high risk of developing it, it’s best to talk to your doctor about the best treatment plan for you. If you’re in need of a cardiac surgeon, Dr. Peter Mikhail performs mitral valve surgery and aortic valve surgery in the Tampa, Clearwater, and New Port Richey areas in Florida. To book a consult, click here or call 727-312-4844.

Older Posts

MITRAL VALVE BLOG

Facts About Aortic Stenosis

Things to Think About Regarding Heart Valve Surgery

What is TAVR?

What is infective endocarditis?

What is Mini-AVR?

Consumer tech: Top heart rate monitors of 2017

Changes to Make to Prevent Heart Disease

How Yoga Benefits the Heart

Your Heart Likes Good Fat!

Stats on Heart Disease

Time in the Sauna Can Benefit the Heart

Aortic Stenosis 101

What is Structural Heart Disease?

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