Something else to consider, Trina. Many surgeons open the pericardium when performing OHS, but then they do not re-close it. A natural, fully enclosing pericardium may act as an insulator keeping the heart from being "seen or heard" under normal circumstances. Absent the sealed pericardium, it is possible that some higher level of sound or vibration may be seen or heard by the patient. Most of us who have this side-effect soon get used to it and it drifts off into "non-issue" status.