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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.

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.

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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.

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.

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.

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