Mechanical valve noise

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

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.
 
Clicking away.....

Clicking away.....

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
 
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.
 
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
 
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
 
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.
 
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.:)
 
Ticking

Ticking

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
 
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