Al - My Brother in law has one of the Starr Edwards installed in the early '70's and while it has started to leak a little, it still works just fine. He may need another valve replaced in the near future and if so, they will replace the Starr Edwards as well. If you guys think your newer valves are noisy, you should listen to one of these babies. By the way, I asked my brother in law if he had any horror stories about Coumadin given that he is certainly a long time user. He really only had some minor stuff to talk about, and he remembers the early testing procedure. Chris