Hello All

[heartman77]

Im new here today....but having AVR surgery in 8 days.....im very fortunate to have an excellent surgeon....He recommends me having a St Jude valve since i am only 55 and could need one or more resurgeries if i live as long as my parents and grandparents...Ive been reading for days and days everything i can find of others experiences to help me make my final decision on the St Judes or an Edwards Pericardial Valve. I think I could handle one more pill a day and would be diligent to keep tabs on my INR #s. My other concern, altho it may seem trivial, is that i am one of those people who needs quiet to be able to sleep. If those of you who have gotten a mechanical valve could tell me how you are affected by any of the possible sounds your mechanical valves make when trying to fall asleep, i would REALLY appreciate it....thanks a lot...ill be monitoring this site hourly if not more frequent till my surgery on the 9th of june..2010.....thanks all and God bless......PS....I am Address removed for members safety .....id love any info

 

[ARGreenMN]

Great question Heartman. I got the St. Jude Regent. I can hear every beat pretty clearly. It's hard to describe, but I think the ticking comes from the inside - like the sound travels up my neck to my ears. Don't think I'm hearing it outside my body. Although, my daughter can hear it from 6 feet away on the couch (she's young and still has good ears). They say that will get a little better as the surrounding tissue heals (had surgery 3 1/2 wks ago). It's not a problem for me as far as keeping me awake, other than it makes the irregular beats I'm having a lot more noticable. But when it's ticking nice and smooth, it's not a problem for me. I'm confident I'll be fine with the ticking - in other words will be able to ignore it. My surgeon did say that he likes to give the Regent to big guys like me (aka fat guys - I'm 30-40 lbs overweight) and he likes to give a different one to the skinny guys because the Regent is a little louder. I don't remember what the name of the one is he uses for skinny dudes. But the good part about the Regent is it requires less anti-coagulation than traditional valves (my recommended INR range right now is 1.8 - 2.2, vs. the traditional 2.0 - 3.0). And I noticed a fairly big difference in how long it took bleeding to stop from finger pokes at 2.7 the other day vs. when I've been at 2.2 or 2.1. Hope this helps a little - let me know if more questions about the ticking.

 

[Luana]

Heartman, I have a St. Jude mechanical valve also and I barely hear it when I go to bed. For me it's quieter than the way my heart used to sound before surgery when I put my head on the pillow.

 

[heartman77]

Thanks Andy....

Thanks Andy....

Thanks a lot Andy......how big a guy are you? Im 5'10" and 215 lbs..so not as big as some but overweight also....lol...but i havnt heard any mention of different model St Judes for different size people till now...but thats interesting......Ive read so many stories of people with the St Jude...some who are driven crazy and some who hardly know they have a mechanical valve in them...I have just had problems in the past with being able to sleep and i know how i am....so i am hoping if i make the choice for a St Judes vs a Tissue valve...that i can adjust to the sounds. I hope you are correct and that as time goes on your body healing will quiet yours down even more......glad i found you on here today....im laying low and not doing too much physically now so as not to aggravate anything before surgery. This all came up after i lost partial vision in my left eye when a piece of plaque broke free from my aortic valve. Of course the reason for the loss of sight wasn't known for 24 hours after i was rushed from the ophthalmologist to a cardiologist and then for several tests. I guess now the loss of sight was a warning that i wasnt going to last long without some surgical intervention in my heart. So thank God for the eye problem. Its a gorgeous 85 degree day in Buffalo...how is it where you are?

 

[heartman77]

thats good to know Luana...that is one big concern of mine....the Coumadin i can learn to live on and keep regulated....I dont drink and i easily watch my diet.....its the sleep issue that has me concerned.....how long ago did you get yours?

 

[Bill B]

I have a St Jude Master and I am a small, thin guy. I was worried the valve might make a racket, but I barely know it's there. I keep getting asked if the "click" bothers me, but mine does not "click". I hear a "thump" that is muffled and sounds rather non-mechanical. Now, the noise and pulse wave was much more noticeable early after surgery when I was anemic and my heart rate was elevated into the 90s. That did make it hard to get to sleep. But gradually over 2 weeks my heart rate fell and the noise declined. Now my heart rate is about 60, occasionally lower (49) because I am taking metoprolol for blood pressure control and I am perfectly comfortable with the St. Jude. I gather some people are annoyed by a clicking noise which in some cases can be heard by others. Interestingly, if I leave my mouth open, the noise is amplified by my lungs and is probably loudest coming out of my mouth, but that's still not very loud and is inaudible to others. And if I breath in, the valve is much louder - that is perfectly normal as cardiac output increases dramatically with a deep inspiration. So, don't be alarmed by that sensation. It's a normal physiologic reaction to a fall in chest cavity pressure with a breath in, allowing the heart to fill more.

 

[heartman77]

Bill...thanks for the reply....how old are you that you opted for mechanical rather than a tissue valve? Are you retired also so that your surgeon considered you have a safer lifestyle to be on coumadin? Thanks...Mike

 

[Mentu]

Mike, welcome to VR. My own valve is silent but, last year, I asked this same question of my Uncle who had a St Jude. Uncle Bob said he was aware of his valve in the evening when he went to bed and after a short time found the sound very comforting. (My Uncle was 52 a the time of his AVR and I was 59.) I would be surprised if there are very many people who are truly troubled by the valve that has just saved their lives. However things go, welcome aboard.

Larry

 

[heartman77]

Thanks Larry......how old are you that you opted for the Tissue valve? or was the coumadin the factor that made you decide against mechanical? Im just always curious so i know all the good reasons people in different circumstances base their decisions on.

 

[Jkm7]

When I was choosing which valve, my surgeon said very frankly he could never predict which patient's valve would be louder than someone else's. He said it makes no difference body size, weight, broad chest or petite little female. Sometimes the most petite, little lady has the quietest valve and the big, barrel chested man has one so loud it can be clearly heard.

That was one of the reasons I chose tissue valve. I did not want to take the chance I'd be the person who got a loud vvalve. I can't stand the sound of a ticking clock and also need quiet to sleep.

Best wishes while you wait for surgery. Many of us really have found the wait is the hardest part of the whole experience.

 

[heartman77]

Thanks JKM.......out of curiosity...how old were you when you got your valve?

 

[Jkm7]

Around your age - slightly older.
Valve surgery was my second OHS in four years. The first was not valve related. My valve went bad after that first surgery.
I knew what I was facing and still opted for tissue vs. mechanical even if another surgery could possibly be in my future.
Taking coumadin daily was not as much my issue with it as much as the need to handle ACT when needing other medical/dental procedures. Some situations worried me. I really did not want to be on it for the rest of my life though I was aware some people with tissue valves end up on it anyway if they develop a-fib.
As it turned out, my short course of coumadin after getting my valve (it is common for some surgeons to order coumadin for 2-3 months while tissue valvers grow their own tissue over the valve seat), I required huge dose to approach therapeutic range. I was taking such large amount my surgeon had me stop it two weeks earlier than he had planned. There was no way to know in advance I would require such a large dose daily.

Each of us has to decide what is right for them. There is no wrong choice except to not choose to have the surgery.
Tissue was absolutely the right choice for me and I am grateful that is what I got.
Best wishes to you. It is very hard making the decision.

 

[heartman77]

You are right JKM.....ive been studying and reading and agonizing over this for weeks........thanks for your imput.......Mike

 

[heartman77]

Bill how do you find it is to be on coumadin?

 

[Freddie]

Welcome to the forum Mike, if I may butt in with your questions to Bill. I hear a click or a tick with my mechanical, and yes it did bother me for the first couple of weeks while laying in bed. But what I've learned from here and it's so true is that your body/hearing is so in-tune with this new part you can't help but hear it (if you even do hear it), but in time, as your body heals you may not even notice it.

As for coumadin........the way I look at, it's just pill that I have to take.

 

[ARGreenMN]

Thanks a lot Andy......how big a guy are you? Im 5'10" and 215 lbs..so not as big as some but overweight also....lol...but i havnt heard any mention of different model St Judes for different size people till now...but thats interesting......Ive read so many stories of people with the St Jude...some who are driven crazy and some who hardly know they have a mechanical valve in them...I have just had problems in the past with being able to sleep and i know how i am....so i am hoping if i make the choice for a St Judes vs a Tissue valve...that i can adjust to the sounds. I hope you are correct and that as time goes on your body healing will quiet yours down even more......glad i found you on here today....im laying low and not doing too much physically now so as not to aggravate anything before surgery. This all came up after i lost partial vision in my left eye when a piece of plaque broke free from my aortic valve. Of course the reason for the loss of sight wasn't known for 24 hours after i was rushed from the ophthalmologist to a cardiologist and then for several tests. I guess now the loss of sight was a warning that i wasnt going to last long without some surgical intervention in my heart. So thank God for the eye problem. Its a gorgeous 85 degree day in Buffalo...how is it where you are?

Mike, I'm 6'2" and 245 lbs. I can't remember if the other valve (the one he prefers on skinny dudes) was a St. Jude or some other brand. Just know he preferred the St. Jude Regent for me. He wasn't 100% sure until he got in there whether he'd be able to use it - guess it depends on the size of the opening and other factors - but he had a plan b and plan c in case the Regent didn't fit (but it did). I live in Minneosta, and it was decent this morning, I think got up to about 80, then kind of stormy today - nothing major, just rain and a little lighting.I was initially leaning towards tissue (afraid of needles, didn't wanna give up drinking, etc., etc.), but ended up doing a 180. As I learned more, you don't have to give up drinking, just watch it a little closer, and most of the other scary parts are not that bad either. So far (3 wks after surgery) it hasn't been an issue for me - other than the finger pokes to get tested which I don't like.

Keep asking questions! And let me know if you want more details about above.

 

[Mentu]

Mike, to answer your question, I was 59 last September when I received my new valve. Because my Uncle experienced tissue growth that degraded the function of his St Jude valve, my surgeon believed it likely that I might have the same problem. In such instances, he said tissue valves can continue functioning where a mechanical may not. My Uncle's valve was replaced with a porcine valve. Whichever valve once chooses, there is no certainty that something will never interfere. I take an Aspirin instead of Coumadin but that is not the end of the matter. Last week I got a bacterial infection. My Doctor said it was necessary to begin treating this aggressively until she knew the species of bacteria and that this will be the pattern she follows in the future to preserve my implant. A couple days later lab tests showed that this particular bug is known to damage heart valves, including bio-prosthetics, so I will be taking 2 grams of antibiotic daily for the next month. As with any topic, the more one learns of the details the more you appreciate that the choice of tissue v. mechanical is not a simple matter of whether or not one must use anticoagulant. I am glad to see you are reading; the more you learn the more comfortable you will be with your choice precisely because it was not easy to make.

Larry

 

[Lily]

Larry - Hope you'll quickly and fully recover from the infection!

Mike - Welcome For what it's worth, my old defective native valve had just kind of sloshed its strong murmur for such a long time that even the beats of my new tissue valve were loud in my ear for awhile. Especially when I slept on my left side. It resolved for me after a few or several months. (I may have missed it but I don't know why your aortic valve is being replaced, whether it's bicuspid or not.) Best wishes

 

[Philip B]

Valve Noise

Valve Noise

Body acoustics tend to vary among individuals and valve noise isn't even constant for individuals. I've had my St. Jude Regent for over three years now; sometimes I notice the noise it makes...sometimes I don't. Even on those occasions when I do hear it, it doesn't keep me awake at night.

For the first year after my surgery, every morning when I woke up, I listened for the sound of my valve at work. It was reassuring to hear it and know that I was alive. My wife would often put her ear on my chest and comment that she was glad to hear it clicking and ticking.

Most of us who opted for mechanical valves often comment that the coumadin thing is no big deal. It really hasn't presented any big challenges for me. I'm as active as I was before AVR surgery. Sure, I bruise and bleed while pursuing an active lifestyle, but I did that before I started taking coumadin.

I sincerely believe that any valve choice you make to prolong your life is a good choice. The decision you make regarding which valve is less important than the choice to have your defective valve replaced with something that works better.

-Philip

 

[Luana]

thats good to know Luana...that is one big concern of mine....the Coumadin i can learn to live on and keep regulated....I dont drink and i easily watch my diet.....its the sleep issue that has me concerned.....how long ago did you get yours?

My surgery was in November, so it's just past 6 months now for me. While I rarely hear the valve at night, I am aware of it if I wake up around my usual time and then decide to go back to sleep. I thought maybe it was the beta blocker wearing off and started taking it later at night, but still hear it during daytime. I have no idea why. When I do hear it it doesn't bother me; it's not loud, though I am aware of it, if that makes sense.