Mechanical valve noise

[Rick W]

Can anyone tell me if you notice any valve noise with your mechanical valve and if you have gotten used to it or just what your experience has been. Also, I have read that many people on coumadin for their valve are not all that troubled by the risks or inconvienence. What I also would like to know is if anyone had originally decided on a tissue valve for AVR and later changed their mind to a mechanical valve. Additionally, I am concerned about this phenomenon of valve "tissue impingement" over time on a mechanical valve which lead to a re-operation to correct it and how long it took to develop. Yes, I am still working through this most important of decisions, valve type.

Rick

[terryj]

My husband had decided on the mechanical valve originally so I can't help you with that but my husbands ATS valve sounds like a watch ticking. After 4 years we hardly notice it except when we go to bed and its real quite. But, when someone new starts where my husband works they usually ask him why his watch is so loud and then watches their faces when he tells them its his heart. He is 56 and works in a Fiberglas factory as a Maintenance Mechanic and the younger guys have a hard time keeping up with him. They can't believe he has had OHS.

[ALCapshaw2]

Welcome to our world Rick.

After considerable deliberation, I asked for (and my surgeon agreed to) a Bovine Pericardial Tissue Valve.

Once we was 'in there' and saw how much scar tissue damage had been done by Radiation Treatments for Hodgkins MANY years ago, he implanted a St. Jude Mechanical Valve which of course meant lifetime Coumadin therapy.

Other than one severe bruise (puppy induced), I have not had any problems with Coumadin. I was concerned about having to go OFF Coumadin for invasive procedures, which I DID do recently, with Lovenox Bridging Therapy, for an upper endoscopy and colonoscopy with biopsy. It was NOT as bad as I had imagined and I even learned to give myself the Lovenox shots. You (WE) just have to redefine our sense of NORMAL.

As 'they' say, "Heart Disease isn't for Sissies!"

OCCASIONALLY I will hear my valve but again, it is not as disrupting as I had feared. Usually this occurs when I have a 'pounding' heartbeat or while laying in certain positions in bed. I find it to be a 'soft sound' that is NOT annoying and can generally make it go away by repositioning myself. Sometimes I will FORCE it to become loud enough to hear by inhaling and holding my breath, just to listen to it.

Have you looked at the third generation Mechanical Valves (On-X, ATS, Sorin) ? Those offer some interesting advancements. I 'assume' you have been reading in the Valve Selection Forum. If not, then by all means spend some time there for more insights.

EVERY valve has positive and negative aspects. It seems that many people end up choosing the valve whose negative aspects they can best live with. It becomes a very personal decision. After researching and thinking about the options, hopefully you will arrive at an answer that 'feels' right for you.

Best Wishes,

'AL Capshaw'

[wxman]

Had a St. Jude valve implanted in July of 2003. I have never been able to hear it. And so far...coumadin has not been a big problem.

[kingpeta]

I had a mechanical valve implanted and yes I can hear it. It is a soft sound as Al has said and I don't notice it much except at bedtime. It should be noted that I'm only 5 weeks post-op so the sound may change for better or worse as healing progresses. I take warfarin and it is just another pill as far as I'm concerned. No problems with it yet. You need to keep learning and make the decision that's best for you. I felt I didn't have much choice. At my age (45) the surgeon pretty much recommended mechanical and I would suggest avoiding re-operations as much as is possible! OHS is not that bad but not much fun either.:)

[Christina]

Rick,

I am on my second mechanical valve. First one was a Sultzer Carbomedics (21mm) one I could hear loud & clear. I didn't think that was funny and found that one to be cumbersome. After 11 days it was replaced with a St. Judes and this one is a breeze compared to the first one. I don't hear it unless I am on my left side and it is very quiet in the bedroom. It's been over 5 years and most days I don't even think about it anymore.
As for Coumadin. I hometest and wouldn't want it any other way. I don't answer to anyone. I just need the doctor to prescribe the medicine and that's it.

[Johnny Stephens]

I have two mechanical valves, so when I say I sound like a watch it really is true :D . It's a very delicate, precise sound. I almost never notice it - in fact, I can't hear them now. Occasionally if I'm cranked-up on Starbucks and stressed out it will be noticed by a co-worker if we're in a quiet, closed office. They all know what it is, and are techie-types so they actually think it's really cool. In normal, day-to-day walking around town, and in public, they have never been noticed by anyone. I actually like the sound.

[jeffp]

I have a St. Judes mitral valve. The coumadin hasn't been much of a problem so far as bruising and bleeding but trying to keep it in range is a task at times. I home test and adjust as needed, but I find changes in exercise level make more difference in levels than food does. So far as the sound, it was very noticible at first. Sounded like taping two dimes to your finger tips and tapping them together, a high frequency tap, tap, tap. Mostly, I hear it in the back of my neck (or so it seems the sounds comes from there) - weird, huh? It got either less pronounced over time as tissue seated around the suture ring, or I got used to it; though my wife notices it less as well. The mitral valve position is subject to a higher pressure differential than the aortic so I think that the aortic would slam shut with less of a bang (though I hope I never have both to compare with!) When I get nervous or excited it's louder. Don't try to play poker with a mechanical valve - they'll know if your bluffing. (Faking during sex doesn't work either - its like having an emotional readout for the outside world - I guess being a international terrorist negoitator would not be for us.):D

[Nancy]

Here's a poll I did on the Coumadin issue.

http://valvereplacement.com/forums/showthread.php?t=12178&highlight=hate+Coumadin%22

My husband has two mechanicals and he doesn't even hear them. I can hear them and his docs can too from several feet. He's had one for 28 years, and the other for 6 years.

He sleeps with a sound machine on though because he says the valve sounds reverberate on the mattress.

[Granbonny]

3 years, 8 months later..never hear mine either..:) Must be working..:p Or I wouldn't be here typing..:D Bonnie

[Lisa in Katy]

It's been 7 1/2 years. I do hear it occasionally, but hardly notice it even at night. Today I had a student notice it, but I was leaning over the desk behind her, which seems to be the position that makes it louder. In a very quiet place, others might say something about a loud watch.

I really don't think about Coumadin. The only thing that really annoys me is how easily it is affected by antibiotics. Luckily, I'm not sick often, and other than the standard cleanings, haven't had any dental work, so this has only been a problem a few times. I eat what I want, do what I want, have my blood tested every couple of months, and go about my life.

My brother had his surgery 12 1/2 years ago, and other than some minor problems when he stopped taking Coumadin for an extended period of time (about 5 years I think), has been okay. I can't even hear his valve when I am trying. As you can see from the Coumadin comment, he is not very compliant, which I don't recommend, and has probably participated in some non-recommended activities, but is doing fine.

[INRtest]

I have a St. Judes mitral valve... When I get nervous or excited it's louder. Don't try to play poker with a mechanical valve - they'll know if your bluffing... - I guess being a international terrorist negoitator would not be for us.):D

Jeff -- I rendevouzed with an old friend and spent the weekend in Reno & Tahoe. I lost a couple of bucks at poker and couldn't understand why. Guess the other players knew what I had. I'm going to look into getting a porcine installed next time I go to Nevada.

Rick, neither the noise from the valve (what's a little occasional clicking, anyways?) or Coumadin should concern you. As I told my friend the other day, I'm probably in better shape today than before I got sick last yr. because I exercise regularly and I am now carefully monitored by drs. I expect to take this thing to the grave with me -- but not before my 90th bday.

No matter which valve you choose -- it will be the right one for YOU.

[perkicar]

I notice mine (like many others) at night or when I'm in a quiet room. I've never had anyone tell me they could hear it, although my massage therapist leaned close and could hear it and it kind of freaked her out LOL.
As for coumadin--like anything else, I just have to remember to take my pills. I'm doing better now that I take it with my morning pills--I was sometimes forgetting to do it in the afternoon as a separate pill. Haven't gone to home testing yet, but it's convenient to drop by the docs office to get my finger stick done. I've gone out of range once, but that's it.
I do need to schedule my colonoscopy and will have to do the bridging thing, which makes me kind of nervous, but it's a necessary evil so I'll get through it.
Carolyn

[Mike C]

Hi Rick,

Like others said, I tick like watch/clock. I hear it when its quiet, others can hear it if next to me and quiet, sitting in a parked car with no radio for example. I got used to it very quickly. Most of time it is actually comforting, only time i dont like it is when I am checking on sleeping kids, it seems very loud at those moments.

Coumadin...its only been 3 months but so far its pretty easy...sometimes i wonder if i maissing something because people talk like its a monster.
(although i am not sure i will like this 2 beer limit i hear about).

for me at 35, ill deal with these minor issues to delay another surgery as long as i can.

[hayden]

I have had mine since August 2004 and I hear it most of the time!!

[ClickerTicker]

Funnily enough, despite my handle, I vary rarely actually hear my valve "ticking". My wife says she has occasionally, but only when she's very close.
What I have found, is that I experience more of a "pressure pulse" from it. Not noisy as such, but noticeable on occasions when it is very quiet. Sort of like you get if a ball-valve on the plumbing shuts off suddenly. Funnily enough, it seems to be exacerbated considerably if I wear earplugs in bed (my wife can sometimes snore). Strange effect, but once you've tuned into it you have to work to ignore it.
Certainly not noticeable in a more noisy environment, I wear ear defenders sometimes if I want some really quiet time - sort of like big old Keff studio headphones without the audio bits - and it's not noticeable then, even in a very quiet environment. Only if my ears are blocked am I aware of it.
On the other hand, if I'm mowing the lawn with my trusty Shure E2C sound-isolating in-ear earphones connected to my MP3/FM Radio and heavy ear defenders over those, (I really must get that damn lawnmower serviced) a jackhammer could be going in my chest and I'd not notice... :rolleyes:
Anyway, as my cardiologist said, the only time to worry about it is if it stops:D
...Not sure about the two beer limit... I'm just getting warmed up at that stage :p

[Rick W]

Thank you to everyone who responded to my questions, it is very helpful. Some things I think will need to be answered by my surgeon, if he even knows. I am still wondering what kind of guarantees there are that a mechanical valve assures no future surgeries for its own sake.

Rick

[Nancy]

Mechanical valves are extremely well made. However, sometimes the attachment area can develop a leak. It is sometimes caused by a body tissue problem. But this is not a common thing. Endocarditis can cause problems with tissue and mechanicals.

The vast majority with mechanicals have no problems.

There aren't any guarantees with ANY valve. You can only go by the track records of a particular valve. It doesn't tell you what will happen to YOU. You can get a tissue valve, and have to go on Coumadin anyway for afib.

[Karen7]

Hi Rick,

I originally chose a stentless porcine valve and the night before my surgery, had a change of heart and went with the mechanical valve. My reasons were: the diagnosis and waiting for surgery had been far harder than the operation portended to be. Choosing a tissue valve meant that I had to calculate in the year or so of failure for that valve, not just the surgery (all those tests and doctors appointments!) and also, my family was falling apart from the stress of impending surgery. I wanted to save them if I could. I'm now six weeks post-op and the coumadin has been no big deal at all. The click from my carbomedics 23mm is very tiny. It reminds me of when I was little and I leaned my ear on my dad's wrist watch. I can only hear it if it's silent in the room. No one else can hear it unless they put an ear to my chest. Needless to say, very few people are allowed to do that.:)

[BDMc]

Rick, I have a Shiley mechanical valve. I noticed the ticking the first time I got up after OHS to got to the bathroom. I thought it was my watch, no, must be a dripping faucet, no it's my new valve! Took a little gettting used to, but doesn't bother me at all. I had a phtographer taking my picture once, and he asked what kind of valve it was. I was surprised he could hear it. Had a short affair with a woman that said she couldn't sleep with it, but my long term loves never complained. I have had people hear it in elevators... Warfarin is something you learn to live with. I like to think it's much easier than the insulin some people have to take. Best of luck! Brian

[Granbonny]

Your post on why you chose a mechanical valve was one the the BEST posts I have read on choosing a valve.:) ( with 4,109 posts on VR.Com, I have read many:D ) First time I have read someone to say..the stress of waiting before surgery...and the stress that will come a year before the next surgery( choosing a tissue first time)....because you said the word..calculaing the time.. Most people say..I hope my tissue will last me 15 years, ect....but, have often wondered..if they calulate the last few years..the waiting, doctor appointments, ect...getting ready for their next surgery....Also, the family thing..I never want my family to have to sit in a waiting room and worry about me....My big, burly policeman son needed a good-feel shot..worse than me.:D ..and daughter taking a week off from work to be with me in hospital....I was so lucky to have been married to my hubby for 35 years..and he took great care of me post-op...and still do :) ......I think everyone has their own reasons for choosing a certain valve..and most have thought it out carefully...and ANY valve they choose is a good one..That's why we are all still here.:) Didn't mean to hijack this thread..Just impressed with your post...Bonnie

[Randy & Robyn]

http://www.ismaap.org/51.0.html

This is an article that deals a bit with mechanical heart valve sounds near the end of the article. The entire paper is quite interesting.

Here is the most pertinent excerpt:

Why patients hear heart valve noises

The annulus of the prosthetic heart valve forms an unnatural barrier to blood flow. This is the reason why there are always slight turbulences behind the mechanical valve in aortic or mitral position. In the same way as with a swollen stream, greater turbulences occur as the flow of blood increases through the artificial valve. Not only the cardiologist can pick this up on his stethoscope; sometimes the wearer himself can hear the blood flowing and the tilting disks opening and closing – even without a stethoscope.

Virtually every mechanical heart valve is responsible for creating a certain level of noise. Often the noise decreases as the size of heart valve increases. In addition to noise actually produced by the valve, the human body’s so-called “resonance board” itself plays a role in propagating the noises produced in the mechanical heart valve. It is understandable, therefore, that patients perceive the noises differently.Based on life quality data obtained in the ESCAT study, it was found that approximately 10% of patients are bothered immediately post-operatively by the heart valve noise. Of this patient collective 80% become accustomed to the noise; only 20% of the collective, i.e. 2% of all patients who have undergone replacement mechanical heart valve surgery, find the noise bothersome. Women suffer more from the valve noise than men. In particular the 20-to-30 age group and the 40-to-50 age group develops a strong aversion to the heart valve noise.


What are the advantages of a mechanical heart valve?

The advantage of a mechanical heart valve is the fact that it will last almost forever and that it has flow characteristics that closely approximate those of natural heart valves. With long-term oral anticoagulant medication, thrombogenesis (formation of thrombi) by the heart valves no longer has any role to play.

Other ESCAT study results showed that, with anticoagulation self-management, the incidence of thrombus formation in the first 2 years is just 0.2% per patient year. This is a very low complication rate.

[Mike]

There is a link on the carbomedics.com site that approximates mechanical valve sounds; if you need the exact url I'll post it. My wife says my valves don't sound like the St. Jude valve simulated there, but they sound like that to me when I'm in a quiet environment. The comparison of sounds is quite interesting.

Mike

[Natanni]

Nathan is 7 weeks post op today :)

He first heard the clicking of his Carbomedics valve in the bathroom. For the first few weeks post op, I could hear this ticking when sitting near him. I could hear a more of a 'thud' when we were walking briskly (when we were not actually suppose to be walking briskly at this point in recovery) Nathan would hear something think a little different, not so sharp sounding, and he thought it came from more his neck/ear region. We noticed 2 wks ago that we could not longer hear his valve. I can hear it only if I put my ear to his chest, and better if I listen to his back. It is more like a tiny thump. :D He still feel a little banging in his heart when he is working out at cardiac rehab. I am not sure if he still hears anything when working out, he has not mentioned it.

[Rick W]

It seems valve noise varies widely from hardly noticable to audible from several feet away. Some of the individuals (us valvers) are not bothered by the noise, some say they have gotten used to it, others say that they hear it all the time, and some notice it only under certain conditions. Apparently this issue varies with each of you and with the type of valve manufacturer, St. Jude being the most common for sure. I wonder how the ON-X owners are doing in specific. As I mentioned, the concern I have with mechanicals is; noise, coumadin, and head or other trauma. Also seems other medical procedures required are influenced by a mechanical valve. Any further input from the forum members would be much appreciated.

Rick

[Karlynn]

i am 48 had surgery in sept 2005, had bentall process, it's loud, i am very fit doc, says chest is big for weight lifting in gym. says i have to amplifiers for chest, plus no body fat. it's kind of fun to say to people listen to this they freek out. wakes me up a lot in the middle of the night. you have to have a great sence of humor for this valve. i tell my kids a last words will probally be (oh shit) or ( ut oh!)

Welcome Mark!

Your valve noise will decrease as your heart heals - and with a 9/05 surgery, it is still healing. I only hear mine at night when I'm on my side, or in a tiled, quiet bathroom.

[Geo]

Rick,

I am in the same position. 48 yrs old and needing to decide by 2/2 for an AVR. My wife has a MVR, St. Judes. She or I don't even hear it. Maybe when it is real quiet, it sounds like a timex watch. no big deal. I am not concerned in the least about that issue. She is managing the coumadin. She basically eats what ever she feels like and yes has a few drinks when she wants. Again, that seems fine. My biggest concern is dealing with other medical/drug interactions. I have a back that goes out and have been taking naproxen. I was told that I could not take that due to bleeding. The choices are vicoden or tylenol with codine and a muscle relaxant. That may work. OK, then I am thinking about a bleed somewhere, or what if I will need another surgery, or an MRI. I have never had any surgery in my life so I have not walked in the shoes of some of these wonderful people who are offering their opinions. It does scare me to think about OHS.

George

[Mb]

My husband has two mechanical St. Jude valves. Most of the time I do not hear it.....if it is quiet in the house, he is reading the newspaper, in our tiled kitchen, I will hear it. He wears one hearing aid, so he doesn't hear it EXCEPT for two conditions......if he opens his mouth, you can (and he can) hear his heart. He also says he can hear it in the phone. Says it is odd, to hear his heart beat when he is waiting "on hold". Combine this with the fact his heart beat is irregular due to chronic afib.....weird.
Marybeth

[scouch]

Rick,

I had AVR 4 months ago and was fitted with a mechanical valve. I had originally wanted a tissue valve but after several different surgeons and cardiologist met, they decided that the mechanical valve was best for me. I pursued some other opinions and they all agreed with the mechanical valve decision. My greatest fears about a mechanical valve were the clicking of the valve driving me nuts and taking warfin. Now, 4 months later, I wish that I would have not wasted so much energy worrying about these two things. I don't notice the clicking unless I am in a real quiet room. It only keeps me awake if I am wired on caffine. My wife says it sounds like music to her! The coumadin therapy is not a problem at all. I get my blood checked regularly and the doctor makes adjustments. I am 40 (spent my 40th birthday in ICU after surgery) and am thrilled that my mechanical valve should last a long long time. There is still the possibility of future surgery but it is much less than if I had a tissue valve and the thought of another replacement surgery makes me cry! I am thrilled with my mechanical valve. Good luck!

[DinahS]

Hello!

I just had an AVR on Dec 28th, and got a St. Jude Mechanical Regent Valve. I can't hear a thing. I heard it with a stethoscope in the hospital and can hear it if I put my head on my shoulder and listen really closely. It's kind of strange. I was so paranoid about hearing it and being on coumadin, but it has all been just a breeze. I was worrying myself literally sick over it for NOTHING. I haven't noticed the sound and being on coumadin is no different than being on anything else. I don't fell any different than normal. I was really nervous about it too, but decided to go with mechanical b/c I know that I absolutely DO NOT want to ever put my family through that again. This is the 2nd OHS for me. This one was a breeze too compared to the repair. I know I made the right decision now, and would do it again in a heartbeat!

This is just my experience, and I was on this website for nearly a month before my surgery reading all kinds of experiences. This website is full of wonderful people who have either gone through or will be going through your same situation, and they helped me get through alot of my anxieties and answered tons of my questions.

[Gail in Ca]

The porcine valve I had for 11 yrs was wonderful.
Now I have a carbomedics valve and, although I have gotten used to the sound, it still bothers me often. When I read others comments that they aren't at all bothered by theirs, I am amazed. Maybe because I am a musician it bugs me more. When I get irregular beats, it really drives me crazy to hear that valve noise. Deafness runs in my mom's side of the family, so when I'm old, maybe I won't hear it much:).
For me coumadin has been kind of a hassle. I get huge bruises, nose bleeds, and usually when I cook a family dinner, I end up cutting myself and that's no fun.
Obviously, each person reacts differently to their valve.
Gail

[Mama2Rylan]

Hey!

I had my OHS just this past August. I was alot like you, didn't know which to choose and often changed my mind. When I went in for surgery, I had my mind set on mechanical, and due to my complicated situation during the surgery, that was the only thing they could do. So far I am loving it! I mean I feel great and the coumadin isn't as bad as I thought it was going to be. I just have to remember to take it every night (which isn't that hard, since I have like a million other "heart" pills to take:p ) and get my levels checked. Lately, my levels have been off a little bit, so that just means a few more trips to the doctor, not that big of deal. And most people have the option of home testing kits, which is also a big plus.

As far as the "noise" goes, there are times that I do hear it, like if I'm taking a bath...or laying in bed when it's totally quiet. Other then that, I don't notice it. I might be just getting used to it, but no one else has commented on it. This might sound a little weird, but the little "tick-tick" gives me a little comfort, hey, at least I know its working;)

I think the best reason for a mechanical is that it reduces the chances for another surgery. I mean with a tissue, I know that I would have needed at least one more. So this gives me a little more security, knowing that prolly won't be the case for me anymore. But whatever you choose, just know that it's your choice, and either one will be a good one:D