Mechanical Valve Noise and Quality of Life Study

[newarrior]

"Mechanical valves generate a clicking sound that is often audible to patients and even patients’ relatives [7, 8]. However, cardiac surgeons may underestimate the impact of this continuous valve noise on patients’ QOL, unlike life-threatening complications, including anticoagulation and thromboembolic events." "The clicking sounds of mechanical valves are considered a source of disturbance and can result in annoyance, sleeping disorders, concentration disturbances and social embarrassment in some cases [9]. A 55-year-old patient experienced severe difficulty in terms of the “clicking” noise made by the mechanical valve. Thus, he underwent a second sternotomy and a second valve replacement with a bioprosthesis valve 4 months after the first mechanical valve replacement. The authors emphasized that the potential risk of valve noise on patients’ QOL should be taken into consideration when choosing an artificial valve" "If possible, a meeting between patients and someone who has already undergone mechanical valve replacement should be arranged, and the influence of valve noise before undergoing valve replacement should be communicated." The effect of valve noise on the quality of life of patients after mechanical mitral valve replacement in a Chinese population - Journal of Cardiothoracic Surgery




"D. Limb also reported that patients and patients’ partners were annoyed by continuous valve noises during sleep, which may lead to reduced concentration and may be detrimental to social relationships [11]. Thus, we focused on the degree of disturbance due to valve noise and QOL in patients who underwent mechanical valve replacement."

Interesting as I am badly hearing impaired so maybe I won't hear the noise, "We contribute this change in the response to valve noise to physically impaired hearing abilities in those older than 60 years"

Is this valve noise heard as an internal noise or an external noise ?

https://cardiothoracicsurgery.biomedcentral.com/articles/10.1186/s13019-019-0956-1

 

[pellicle]

Is this valve noise heard as an internal noise

for me, mostly as internal, but for others around me they tell me its external

I think it also depends on "luck of the draw" ... it can bother you or you can accept it. Personally I'm in charge of my head, so I accept it. Now and then I become aware of it, mostly when thinking about it (like answering a question like this) or when doing some types of exercise.

PS: on the plus side, I became the first to know about my heart arrhythmias and was able to give the doctor a good description without a stethoscope. I can also take my pulse by just counting them ;-)

 

[pellicle]

Also, I'll see your chinese study and raise you a western one

Quality of life after aortic valve replacement with tissue and mechanical implants​

• September 2004
• The Journal of thoracic and cardiovascular surgery 128(2):266-72

DOI:10.1016/j.jtcvs.2003.12.014

• Source
• PubMed

We sought to determine whether changes in quality of life at 18 months following aortic valve replacement differ depending on the use of tissue valves or mechanical valves. We prospectively studied 73 patients with tissue valve replacements and 53 patients with mechanical valve replacements performed from April 1998 through March 1999 at Yale-New Haven Hospital. Quality of life was measured at baseline and at 18 months using the Medical Outcomes Trust Short Form 36-Item Health Survey. Baseline unadjusted mean quality-of-life scores were lower in tissue valve recipients than in mechanical valve recipients and, for both groups, were generally lower than US population norms. At 18 months postoperatively, quality-of-life scores were greatly improved in both groups and were comparable to population norms (ie, within one-half a standard deviation). After adjusting for baseline quality of life, age, and other prognostic factors in an analysis of covariance, improvements in quality-of-life scores for tissue valve recipients versus mechanical valve recipients were similar. Of 10 (8 domains and 2 summary) scales examined, the only significant difference between the 2 groups was for the improvement in role limitations due to physical problems (Role Physical), which was more favorable in patients with mechanical valve implants (P =.04). The use of tissue valve implants versus mechanical valve implants has little influence on improvement in quality of life at 18 months following aortic valve replacement. Thus, decisions about whether to choose a tissue valve or mechanical valve implant should depend upon other factors such as rates of complications and differences in the life span of the implants.​

​

Underline mine

 

[pellicle]

so basically "life is what you make of it", not what some study tells you it should be.

Like the Buddhists say: change comes from within

 

[gpr100rs]

It's also worth mentioning that biologic valves often aren't "silent" for the recipient. I had Edwards Resilia valve implanted about 18 months ago. When sleeping on either side, I hear a pronounced "lub-dub", especially the "dub" part when the valve closes. Granted, no one around me can hear anything nor do I hear anything except at night with my head on the pillow. No valve is perfect.

 

[pellicle]

No valve is perfect.

^^^this^^^

here's an example: I picked a eScooter as my daily driver which has foam core tyres. I picked this because I totally didn't want to ever get a flat tyre on the way to work, or the way home. Kiddiez on Reddit slam this same scooter because it goes "ker clack ker clack" over sidewalk bump (burst into hysterical crying at the thought ... sniff ... wipes eyes) but 3 years later the tyres are great, and I've never had a flat. The scooter has got me to and from work without ever having an issue.


but I do hear that horrible "ker clack" whenever I go over bumps (and often laugh semi maniacally and may be heard to utter the word ******s)
... but we're not supposed to glorify valves ;-)

PS: when I got a second scooter (don't ask) with pneumatic tyres I found it was a 3 hour job to fix a puncture



its had 3 punctures as well as leaks in half the kilometers of my ker-clack-ker-clack scooter (Mercane Widewheel)


Seems like an allegory for valves (says the man who's had three surgeries): Quiet on the road, but stuff up eventually.

 

[pellicle]

Hey @newarrior
don't forget while collecting various multiple opinions and test results that there is one final arbiter for who accepts the fact of if you are or are not at the level of extreme and in need of surgery

the reality is that even you can't argue with this guy



do please, make a decision and tell the professional you work with that you like that you want to start the process.

You'll feel better once you decide

Best Wishes

 

[Chuck C]

the reality is that even you can't argue with this guy

No, but it might pay to have some full sized Snickers on hand so that you can negotiate:

 

[Warrick]

I hear it as an internal noise,
it's not something I would say I enjoy hearing; I liken it to some sort of water dripping torture treatment sometimes...
Saying that it's pretty easy to NOT hear it and get on with things, you just simply forget to hear it.
I can go all day and then I hear it and its weird like I've just tuned it out.
It bothers me if I let it but I don't because what's the point?

Not something I would like to get sliced up for again just to change the radio station...

 

[newarrior]

I hear it as an internal noise,
it's not something I would say I enjoy hearing; I liken it to some sort of water dripping torture treatment sometimes...
Saying that it's pretty easy to NOT hear it and get on with things, you just simply forget to hear it.
I can go all day and then I hear it and its weird like I've just tuned it out.
It bothers me if I let it but I don't because what's the point?

Not something I would like to get sliced up for again just to change the radio station...

Interesting...I've had tinnitus for 26 years-not thrilled about but I have learned to live with it..Not sure how I could handle another internal or external body sound..I have heard that some mechanical valve recipients have had 2nd surgery to replace the mechanical valve with a tissue valve to remove the noise

 

[MdaPA]

"D. Limb also reported that patients and patients’ partners were annoyed by continuous valve noises during sleep, which may lead to reduced concentration and may be detrimental to social relationships [11].

Isn't "reduced concentration" a good thing when trying to sleep? I can tell you that as a partner to someone who has 2 mechanical heart valves (AV and MV), the noise is actually quite soothing to me. I can count the clicks instead of counting sheep to fall asleep.

 

[Chuck C]

I can tell you that as a partner to someone who has 2 mechanical heart valves (AV and MV), the noise is actually quite soothing to me. I can count the clicks instead of counting sheep to fall asleep.

The other time other people hear mine is when they put their head on my chest. When my wife does this she says that the sound is soothing to her, so I can relate to your comment.

I have also noticed that my cat now likes to climb right up on my chest and get comfortable. It occured to me that he might be doing this because it is soothing to him as well- perhaps he perceives it as a purring of sorts.

 

[thomas999]

I am one of the individuals where the noise of my St Jude aortic mechanical valve has caused me lots of problems. For 35 years I have lost the ability to sleep because of the noise. Those who think they are in control of their minds and can with their mind make it easy to accept, that is good for them but there are many others that are a bit on the emotional side that have difficulty. I have never been able to use mind power to accept the noise at night time, it just doesn't work. For 35 years I've had to take some sort of sleep aid to get sleep, period. Seroquel, Xanax , benodril, etc,etc. I would be willing to have surgery to remove the valve, but I don't think my insurance would pay for it. There are many things in life that are stronger than me, and also everybody else, where we are not in full control of. For me, the noise of my valve is one of those things.

 

[cooperman]

My on-X aortic valve is really loud and thumps in my chest. People ask me about it all the time. Bothered me for a couple weeks at first but I am completely used to it now. Rock steady pulse at 60 bmp so
I can even tell time with it.

 

[pellicle]

I am one of the individuals where the noise of my St Jude aortic mechanical

sorry to read this, have you consulted a therapist? I would suggest that even hypnotherapy would perhaps be beneficial (and is a good low price starting point).

I would also be interested if you were one of the people who had insomnia before surgery and if the valve has simply added another point to your issue.
https://my.clevelandclinic.org/health/diseases/12119-insomnia

Insomnia symptoms occur in approximately 33% to 50% of the adult population while Chronic Insomnia disorder that is associated with distress or impairment is estimated at 10% to 15%​

 

[pellicle]

...
I have also noticed that my cat now likes to climb right up on my chest and get comfortable. It occurred to me that he might be doing this because it is soothing to him as well

as a kid we used to put an old wind up clock (wrapped in a sock) in the basket with a new puppy (that say, we'd brought home from one of my Uncles dogs litters) which I was told as a child was because it helped them sleep hearing something rhythmic. I observed it did and the pups were happier (plural used because we had more than one pup which we did this with over years, but usually one pup at a time)

I suppose younger people are unfamiliar with a what a wind up clock is now ...

 

[Sheenas7]

I hear it as an internal noise,
it's not something I would say I enjoy hearing; I liken it to some sort of water dripping torture treatment sometimes...
Saying that it's pretty easy to NOT hear it and get on with things, you just simply forget to hear it.
I can go all day and then I hear it and its weird like I've just tuned it out.
It bothers me if I let it but I don't because what's the point?

Not something I would like to get sliced up for again just to change the radio station...

I hear it mostly when I sleep on my right side. I would say it’s situational. It bothers me enough so that I move a bit and then don’t hear it. I also would not do anything about it.

 

[newarrior]

I am one of the individuals where the noise of my St Jude aortic mechanical valve has caused me lots of problems. For 35 years I have lost the ability to sleep because of the noise. Those who think they are in control of their minds and can with their mind make it easy to accept, that is good for them but there are many others that are a bit on the emotional side that have difficulty. I have never been able to use mind power to accept the noise at night time, it just doesn't work. For 35 years I've had to take some sort of sleep aid to get sleep, period. Seroquel, Xanax , benodril, etc,etc. I would be willing to have surgery to remove the valve, but I don't think my insurance would pay for it. There are many things in life that are stronger than me, and also everybody else, where we are not in full control of. For me, the noise of my valve is one of those things.

Would tissue valve have been better ? I am a lifelong insomniac, depressive, lots of anxiety and have had full blown reactive tinnitus and hearing loss for 26 years so I dread the ticking as well but also dread future surgeries from a tissue valve

 

[newarrior]

My on-X aortic valve is really loud and thumps in my chest. People ask me about it all the time. Bothered me for a couple weeks at first but I am completely used to it now. Rock steady pulse at 60 bmp so
I can even tell time with it.

How in the god's name did you get used to all that ???

 

[newarrior]

Good

It's also worth mentioning that biologic valves often aren't "silent" for the recipient. I had Edwards Resilia valve implanted about 18 months ago. When sleeping on either side, I hear a pronounced "lub-dub", especially the "dub" part when the valve closes. Granted, no one around me can hear anything nor do I hear anything except at night with my head on the pillow. No valve is perfect.

good god thanks