Are sounds from mechanical heart valves equal for different valve types?

[erik]

Hi all, i am in a process of getting a mechanical valve. Since there are many brands on the market, i was hoping if there is any brand which is more quiet than others?
I am a 43 year old classical musician, so it is not very practical to have a build-in metronome that has always more of less the same pulse :-\, especially when you are playing an allegro piece of music ;-)

Well, i have found some research papers on the topic. Some suggesting that e.g. ATS is more quiet, some don't. I was looking your advice on this matter!
Thanks so much.

Greetings, Erik

Evaluation of valve sound and its effects on ATS prosthetic valves in patients' quality of life.
CONCLUSION
In this study, we interviewed patients and carried out frequency analyses to compare the closing sounds of ATS and SJM prosthetic valves. The results of interviews with patients showed that more than 80% of patients with ATS valves could not hear the valves sounds. According to the frequency analysis of the closing sounds of the valves, peak sound pressure in the ATS valve cases was signifi- cantly low and the peak sound was around 1.2 kHz, while in most of the SJM valve cases, two peals were observed at around 2 to 7 kHz and around 1.2 kHz. Thus, a pattern in the SJM cases might have influenced the audibility of the valve sound. From these results, the ATS valve is considered as an excellent prosthetic valve in terms of the quality of life it offers patients.

Are sounds from mechanical heart valves equal for different valve types?
CONCLUSION:
The study results showed a statistically significant difference in SPLs among the three investigated mechanical heart valve prostheses. The highest levels were in the ATS valves, and the lowest in the SJM valves. These objectively measured SPLs must be correlated with the sound as perceived by the patient in order to determine the annoyance that they cause.

Influence of prosthetic heart valve sound on a patient's quality of life
CONCLUSION:
The present study suggested that the ATS valve surpassed the other two valves on the whole in audibility of valve sound and patient health-related QOL. However, further studies, including the ongoing prospective study, are necessary for a more comprehensive and accurate evaluation of the ATS valve.

Fifteen years of experience with ATS mechanical heart valve prostheses
CONCLUSION:
Few prosthetic valve–related complications were seen with ATS heart valve replacements in this study, and the follow-up results were favorable. The international normalized ratio was maintained in the range 1.6 to 2.0 in patients with aortic valve replacement in sinus rhythm. Not only bleeding events, seen at a rate of 0.19%/pt-y, but also thromboembolic events, at 0.44%/pt-y, were low when compared with conventional mechanical valves. Prosthetic valve noise is low, and this appears to be an excellent mechanical valve from the quality of life standpoint. The ATS valve has an excellent safety profile when compared with other mechanical valves.

 

[FredW]

Hi Erik, Great question you ask and I can't offer any help cause I have a tissue valve. I'll let the MHV folks give you their input.

But, I wanted to share with you and others that tissue valves are not without a build-in metronome. Which is the best description I have seen to describe what I hear. It was all the time just after surgery, but now, after three months, it has faded to hearing it just when I'm trying to get to sleep. I'm taking up piano lessons, so maybe a built-in metronome is not so bad.


Finally, what is ATS? I hate it when acronyms are used in articles and the writer assumes we know what they mean. My Google search shows there is a company called ATS Medical, but their website does not define ATS. Also, ATS Medical was bought out by Metronic, but I could not find ATS on their website.

And really finally, does you surgeon have access to any valve you choose? I thought surgeons have a stock or limited suppliers they use and if you want brand X and they use Brand Y, you need to find another surgeon.

 

[Paleowoman]

But, I wanted to share with you and others that tissue valves are not without a build-in metronome. Which is the best description I have seen to describe what I hear. It was all the time just after surgery, but now, after three months, it has faded to hearing it just when I'm trying to get to sleep..

For the first few months after surgery the sound of my new heart valve, also tissue, was very loud. Then it was explained to me by a very good GP that it takes a few months for a baby to get used to the internal sounds of his or her body after birth, and so it is when we get a new valve, it sounds different from what we are used to hearing so our brains pick up on it and it takes some months to get used to.

 

[pellicle]

Hey Erik

I have the ATS and I think the noisyness of a valve is most influenced from the effects of scar tissue and how that conducts the sound through to the body. Scar tissue is not just visible on the surface, but at all layers of the opening and around the heart. Each subsequent surgery creates more.

A visit to a Dr recently had him observe soon after I walked into his office "Well, that's a real diesel you've got going in there"

I have had three surgeries though and last time I've had remarks from the surgeons that there was not of scar tissue to get through.

I still kinda hear it when stopped in quiet places (hallway and bathroom and my apartment here in Finland which is very insulated bring triple glazed). However when doing anything seldom do. What instrument do you play?

I myself hear a thump not a tick that others hear, as I hear it conducted internally more than via sound that reached my ears via the air Of that is understandable.

From what I've read on other aspects the ATS is an excellent choice

 

[erik]

Finally, what is ATS? I hate it when acronyms are used in articles and the writer assumes we know what they mean. My Google search shows there is a company called ATS Medical, but their website does not define ATS. Also, ATS Medical was bought out by Metronic, but I could not find ATS on their website.

This one: http://www.medtronic.com/us-en/heal...rgical/open-pivot-mechanical-heart-valve.html

And really finally, does you surgeon have access to any valve you choose? I thought surgeons have a stock or limited suppliers they use and if you want brand X and they use Brand Y, you need to find another surgeon.[/QUOTE]
My surgeon has some brands, but not all of them ofcourse...

 

[pellicle]

Erik

ATS was a company (never did bother to learn what the abbreviation was for).

https://en.wikipedia.org/wiki/ATS_Medical

They were acquired by Medtronic

http://newsroom.medtronic.com/phoeni...cle&ID=1770602

Medtronic, Inc. (NYSE: MDT), and ATS Medical, Inc. (NASDAQ: ATSI), today announced that the companies have signed a definitive agreement under which Medtronic will acquire ATS Medical by paying $4.00 per share in cash for each share of ATS Medical stock. The total value of the transaction is expected to be approximately $370 million, which includes the purchase of ATS Medical stock and assumption of net debt.

also, as to what valve it can depend as you suggest on what stock the hospital / sugeon has (often a surgeon has significant influence over what the hospital has). My surgeon prefered ATS (Medtronic) and so while I initially didn't really give a rats arse when I mentioned the On-X to him (some week or two prior to sugery) he indicated he was inclined to ATS and he'd had the most experience with that valve. Also at that time there was no (in Australia) approved aortic graft pre-attached for the On-X and that inclined him to stay with the ATS.

I'm not so concerned as I've not read anything that makes me feel there is a clear case for any of the valves, each are equally good.

Hope that helps

 

[LondonAndy]

I can't help directly on this question as I don't actually know what valve I have! Yes, they showed it to me (or a demo one anyway), and I handled it, but it never occurred to me ask what make. Anyway, I just wanted to say that as somebody who avoids having mechanical clocks in my house because the noise irritates me, and who doesn't even wear a watch, I only notice the noise from my mechanical Aortic valve if I listen for it and the room is quiet. Whether that is because it is low noise or because I have got used to it I don't know. Once a technician doing an ECG commented on ticking, and a couple of times people I have slept with have noticed the slight noise, but on a scale of 1 to 10 of irritation for me it is about 0.02.

If I ever find out what make and model it is I will post!

 

[judy bee]

Hi Guys...I've just joined the forum and this is the first post I've read..
You all are so informed..Wow..
Good Luck Erik..Whens the due date ? and what valve is it ? I mean aortic or mitral?
I've just got back from the Cardiologist who has convinced me that I can't wait any longer for my MVR (Mitral Valve Replacement) and to go for a mechanical valve .
The surgeon had advised me to have a bio prosthetic one..
Like you Andy I can't bear a ticking clock so it's reassuring to read your experiences.
Phew...Lots to arrange if I'm to have it in 2 weeks time..Scary stuff... Any advice much appreciated please..
I'm an ex Londoner in India now and will be having the surgery in Mumbai so really don't know what sort of valves they have available here. Will have to call the surgeon and explain I've changed my mind and am going for a mechanical one now.
I'm sorry I've written on your post Erik..

 

[pellicle]

Hi Judy

..I'm sorry I've written on your post Erik..

don't worry about "recycling posts" ... its environmentally friendly ;-)

welcome aboard.

I've recently been chatting with a fellow who had his Aortic done in Mumbai (a local). He had a St Judes which is not a bad choice by any means.

He reported to me issues which related to post surgical staff being ignorant and arrogant ... made a botch of his AC therapy and were typically "indian" about it from my experiences in the place.

I'm sure you've got a lot to sort out but no matter what, it will all come together and the detail stuff can be sorted out long term

Best Wishes

 

[Seaton]

I’'m still in the waiting room but last year my NHS cardiologist said a mechanical valve would probably be her suggestion when surgery was deemed necessary. When I asked what brand mechanical valves they use at St Thomas’ Hospital, here in London, she said Carbomedics, which I’m assuming is one like this:

http://www.livanova.sorin.com/produc...d-aortic-valve

Sorin Group, who make Carbomedics, merged with Cyberonics in 2015 to form a new UK-based company called LivaNova.

There’s a little video here produced by LivaNova, with mechanical valvers talking about their valve experiences:

https://www.youtube.com/watch?v=AKxxvcUokTo&t=2s

Unfortunately I have no advice to offer with regards to noise production from implanted valves. But it's always interesting to read of people’s audio experience from their little metronomes.

 

[judy bee]

don't worry about "recycling posts" ... its environmentally friendly ;-)

welcome aboard.

Best Wishes

Thanks Pellicle for your good wishes..Much Needed..

Surgery will be in a week or 2.. Am going to put up a separate post about it I think..

Good luck with the waiting Seaton..

If you're still in touch with the Bombay(mumbai) fella Pellicle it would be interesting to have a chat with him please.

Good Luck to us all..

 

[judy bee]

ps.. Pellicle ,is AC aftercare ? Just checking :}

 

[pellicle]

ps.. Pellicle ,is AC aftercare ? Just checking :}

AntiCoaglation Therapy

Also known as blood thinners. With a mechanical valve you will be on them

 

[judy bee]

ah.gosh..so much to learn and so fast...thank you..

 

[pellicle]

ah.gosh..so much to learn and so fast...thank you..

don't worry ... you have the rest of your life to learn the details. We are all born into this ignorant, even old timers like dick0236 will tell you that years ago they knew less.

The only test to pass is to wake up tomorrow and know that its called "today"

See ya tomorrow then ;-)

 

[Agian]

The only test to pass is to wake up tomorrow and know that its called "today"

Something for the stoners out there to contemplate

 

[erik]

Hey Erik

I have had three surgeries though and last time I've had remarks from the surgeons that there was not of scar tissue to get through.

I still kinda hear it when stopped in quiet places (hallway and bathroom and my apartment here in Finland which is very insulated bring triple glazed). However when doing anything seldom do. What instrument do you play?

What did you mean by "not of scar tissue to get through? there was a lot of scar tissue?
I play the guitar btw, not such a loud instrument

 

[erik]

Hi Guys...I've just joined the forum and this is the first post I've read..
You all are so informed..Wow..
Good Luck Erik..Whens the due date ? and what valve is it ? I mean aortic or mitral?
I've just got back from the Cardiologist who has convinced me that I can't wait any longer for my MVR (Mitral Valve Replacement) and to go for a mechanical valve .
The surgeon had advised me to have a bio prosthetic one..
Like you Andy I can't bear a ticking clock so it's reassuring to read your experiences.
Phew...Lots to arrange if I'm to have it in 2 weeks time..Scary stuff... Any advice much appreciated please..
I'm an ex Londoner in India now and will be having the surgery in Mumbai so really don't know what sort of valves they have available here. Will have to call the surgeon and explain I've changed my mind and am going for a mechanical one now.
I'm sorry I've written on your post Erik..

Due date is somewhere end of march. Aortic valve replacement
They also do a lot of Mitral valve repairs. Seems to last longer than the AVR. Maybe you can consider it.

 

[pellicle]

What did you mean by "not of scar tissue to get through? there was a lot of scar tissue?

oh dear ... another phone typing error ... should read as: "and last time I've had remarks from the surgeons that there was a lot of scar tissue to get through."

damn auto incorrect on phone!!!

well with Electric its unlikely that any "close mic" on the guitar in the studio will pick up the heart beat ticks in the quiet passages then ;-)

 

[judy bee]

Due date is somewhere end of march. Aortic valve replacement
They also do a lot of Mitral valve repairs. Seems to last longer than the AVR. Maybe you can consider it.

I have to have a replacement .not a repair...Are you suggesting I consider a mechanical valve ?