Photo courtesy of White Plains Hospital
Dr. Robert Michler takes great strides toward advancing cardiac care for patients at White Plains Hospital in Westchester.
Robert E. Michler, MD, suffers no shortage of accolades or titles. An internationally renowned cardiothoracic surgeon and researcher, he is a leader in several specialties and subspecialties, including complex cardiac surgery, heart transplantation, valve repair surgery, ventricular reconstruction for congestive heart failure, and minimally invasive cardiac surgery. Dr. Michler was also one of the first to perform minimally invasive and robotic surgery on heart patients, and his groundbreaking work in robotics led to FDA approval of his advanced technology for mitral valve repair and coronary artery bypass surgery. We recently sat down with the surgeon-in-chief of the Montefiore Health System and director of White Plains Hospital’s state-of-the-art cardiac surgery program to learn about the latest in heart health for Westchester and beyond.
“There isn’t anything in the world of heart surgery that I haven’t seen and done. What encourages me the most about the future of heart surgery is the ability to begin one day to cure disease.”
–Dr. Robert E. Michler
Dr. Michler, how do you explain the remarkable outcomes of your cardiac surgery program at White Plains Hospital?
The outcomes have been extraordinary, better than national averages, and certainly as good as anywhere in the United States. We’ve been able to achieve a 100% early-survival rate in all of our heart surgery patients, which is superb. It all begins with precise and perfect surgery, which is then coupled with care at every level. From nursing care, critical care, anesthesia, and physician assistants, the entire team follows a very precise treatment algorithm that we have practiced for years at Montefiore Einstein. Bringing that extraordinary success and that extraordinary management style to White Plains Hospital has led to these wonderful results.
What is the most important factor in maintaining good cardiac health?
All patients should regularly see their physicians, especially if they have family histories of heart disease or have been told they have high blood pressure or diabetes. Cigarette smokers, people who are overweight or have high cholesterol also possess the principal risk factors for heart disease. The good news is that all of those can be controlled, and their risk is reduced with good medical care or lifestyle changes. The one thing we can’t control is what’s in a person’s genes. One day, we’re hoping to be able to address even that feature in the human genome. So, for the moment, the most important factor in maintaining good cardiac health is that a patient thinks about it and is serious about engaging with that.
How many hours a week of cardio exercise and movement would you recommend to keep the heart healthy?
It’s straightforward: To be able to maintain a good cardiac activity level, it’s a matter of 10 to 15 minutes of activity that raises one’s heart rate and produces a little bit of tiredness, a little bit of breathing heavy. And if that activity is done on a regular basis, three times a week, it’s amazing what it can do to amplify good heart health.
What is your vision for the future of cardiothoracic surgery?
I’ve had the perspective of many decades performing heart surgery — everything from complex mitral valve repair and pediatric heart surgery to heart transplantation, bypass surgery, and ventricular assist devices. There isn’t anything in the world of heart surgery that I haven’t seen and done. What encourages me the most about the future of heart surgery is the ability to begin one day to cure disease. Right now, the most common operation that we do is coronary artery bypass surgery, which is surgery for blockages in the arteries of the heart. And I think that what we’re going to begin to see are better medications to control the risk factors. Additionally, we’re seeing the start of gene therapies or immune therapies to reduce inflammation in the heart that produces coronary blockages. So, my hope one day is that heart surgery will decline in its frequency because we’re able to slow the rate of progression of heart disease.
What’s one moment in your career that has always stuck with you?
One of the most wonderful days I’ve had in my career was when I operated on a 4-day-old baby, fixed their aorta, which was interrupted [a rare heart condition that occurs when the aorta doesn’t form completely], then operated later that day on a 97-year-old man who needed an aortic valve replacement. Both patients did beautifully, went home, and recovered completely. But the 97-year-old man left the hospital sooner and was back to normal activity quicker, in part because he told me that he had married a 63-year-old woman a few months before his surgery.
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