Mechanical Valves: Why do they click?

[sonavogel]

I realize this may be a silly question, but I would like to know what is making the valve click? A rush of blood going through it? Or is there some inner mechanism that must shut on and off?

Also, I was wondering--from those who have the different types of mechanical valves, and have done the research, have you determined whether or not any models click more (or less) loudly than others? Were you able to actually take a look at the various models, hear them in action (preferably not on an embarrassed human being)?

I have read posts from those who cannot get to sleep because of the clicking--which is saying something! Does this mean that when you are standing with five people in an elevator, all of them silent as you await your stops...does this mean that you sound to others as though you are carrying a time bomb with you, something quite obvious?

Thanks in advance for your input!

Best, Sona

 

[Bina]

Hi sona,
My friend got 2 St.Judes about 17 years ago...when I put my ear on his chest I can hear the tick tick, otherwise nothing.
He said in church when it was very quiet, a lady sitting beside commented on his loud "watch". He said it was his heart valve and she moved away....!!!

I don't hear an actual tick with mine, but I feel it working most of the time and more so in front of glass windows or mirrors.
I thought mine would be noisy because I am thin.....

I have the St. Jude 21AGFN-756
It has a flap that opens and closes with the blood flow.
I'm not talented enough to attach a photo of one, but someone will.

 

[ALCapshaw2]

There has been LOTS of discussion of Valve Noise in the Forums. There is even a Valve Loudness Poll!

Mechanical Valves have Leaflets that rotate. When the leaflets hit their STOP position, a noise is made. If you listen with a stethoscope you can also hear the blood flowing.

In the first few weeks after surgery, it is not uncommon to have a Pounding Heartbeat since your heart has not yet adjusted to having a lower pressure gradient to pump against, versus a fairly high pressure gradient when pumping against a nearly closed stenotic valve. When your heart reconditions itself to your new valve, it will probably 'settle down' and be quieter. If you take a deep breath and hold it, you will probably hear it even louder!

Do a VR.com SEARCH for "noise" or "ticking" or "loudness" and you will find many links.

There is even a Website where you can listen to different types of Valve Noises. Unfortunately I didn't find it in my quick scan. Perhaps a GOOGLE Search would locate it.

Most of us do NOT hear our valves most of the time, and many of us find it to be a soothing and reassuring sound when we do. Body position, ambient noise, room size, and wall hardness are all factors.

'AL Capshaw'

 

[sonavogel]

He said in church when it was very quiet, a lady sitting beside commented on his loud "watch". He said it was his heart valve and she moved away....!!!

Oh dear! This made me smile--although I can imagine how self-conscious one would be at first. But after a while, one gets used to the sound, I figure.

Al, thanks for the explanation--and I will try to find that sound site. That would be of great interest to me.

ETA: Found one! Amazing... http://www.carbomedics.com/patients_how_ticking.asp

Best, Sona

 

[Ross]

Oh dear! This made me smile--although I can imagine how self-conscious one would be at first. But after a while, one gets used to the sound, I figure.

Al, thanks for the explanation--and I will try to find that sound site. That would be of great interest to me.

ETA: Found one! Amazing... http://www.carbomedics.com/patients_how_ticking.asp

Best, Sona

Sona while those supposedly represent the sounds, fact of the matter is, it depends on your body accoustics as to what you hear. What I'm saying is, those samples don't sound the same when inplanted into you.

 

[JimL]

I have a little plastic model of my valve. If I remember correctly (I probably don't), someone here told me to contact St. Judes, and they sent a kit of little collectibles for free, since I'd already bought one of their valves. It has two plastic flaps. I also have a St. Jude keychain metal model.

 

[Cooker]

I have a little plastic model of my valve. If I remember correctly (I probably don't), someone here told me to contact St. Judes, and they sent a kit of little collectibles for free, since I'd already bought one of their valves. It has two plastic flaps. I also have a St. Jude keychain metal model.

Jim,

Did you call or write to St Jude? I would not mind having a valve....one that did not pass inspection. Don't want to buy another one

Tom

 

[sonavogel]

Ross, thanks very much for explaining the difference--I sorta figured that it wouldn't sound exactly like the sound wave files, especially when it's coming from inside me. But I was curious to know what kind of clicking it was--I mean, would I be listening to one of those old wind-up alarm clock ticks, or what. This at least gave me a bit of an idea. And JimL, I think I will contact St. Jude and the On-X people and see if there's something like that plastic representation you got. I'd like to begin to familiarize myself with the sounds.

Not because anything's happening this second, but perhaps because I have the time to do something like that now. Later, if there's ever an emergency, things'll move fast!

Rachel, the point you raise is about as valid as it gets. But I figured, if I was looking at a future where I might be able to click into my husband's sleep as much as his snoring drills into mine, there might be an extra push for mechanical!

Seriously, though, the coumadin and the clicking together really are two factors for me in the determination of mechanical. Coumadin first, obviously. That's something I will be studying carefully, especially on this forum. But stacked against the reduced likelihood of a reoperation (reduced, not impossible), the cons are looking less and less forbidding.

And the pros of a biological implant (no Coumadin), set against the likelihood of a reop in 10 years (the valve will likely last longer, maybe even 5 years longer, but at what percentage of its initial effectiveness?), look less forceful as decisive factors to go bio for me. But there's an awful lot to study, yet.

The operation itself, and recovery, are majors.

Thanks!

Best, Sona

 

[ALCapshaw2]

Sona,

While you have the time, it would be worthwhile to browse through Al Lodwick's informative website www.warfarinfo.com which tells you just about everything you might want to know about living with / on Coumadin. He has a Dosing Guide for $5 that will keep you in range and is a Must Have for self dosing (or checking that your Coumadin manager is doing it 'right'!)

'AL Capshaw'

 

[sonavogel]

Al, $5 is very reasonable for the information--that is a must-purchase, for sure. I suspect a home detection (? home testing is probably the better term) coumadin device will become more common (esp. with insurance companies) over this next decade. That too will make proper dosing easier and more consistent, no?

From some of the posts I've read thus far, it's become clear that it's not so easy to secure the services of a good (knowledgeable) coumadin manager. Add to that the having to trek to an office, wait, be tested every three weeks or month...and over a lifetime, that can be wearing. So home testing would make the situation more comfortable. Provided, of course, the home testers prove reliable over the course of time.

My father-in-law had to be on coumadin for the last five years of his life (diabetes), and I think--have to check with my husband--toward the end, they bought a home-testing machine.

I'm not sure which post it was--or whose (yours? Starfish?), but someone suggested asking your cardio for a trial prescription of coumadin for, say, five days or so, to try it and see how it affects your system. I thought that was a very, very good idea.

Best, Sona

 

[ALCapshaw2]

Yes, Home Testing is becoming quite popular among our members. It is VERY common in Germany and other parts of Europe.

I believe Medicare covers Home Testing and slowly the insurance companies are starting to come around. Many of our members bought their instruments out of pocket (around $2000 I think) and also buy their own test strips.

Studies show that the BEST Results (i.e. most stable INR's) are with Home Testers who have learned how to test and manage their dosing. Some 'supervising' Doctors ask their patients to call in their INR's (each time or monthly) and to come in for a clinic test once every 6 months or year. Others simply have learned to trust their patients after years of successful home management.

Real Coumadin Clinics come in second. Solo practicioners tend to vary all over the map. Some are good, some are terrible.

There is a forum for Home Testing with contact info for purchasing home test equipment. QAS is one source.

'AL Capshaw'

 

[John & Joann]

The original Starr-Edwards valves were MUCH louder than the current valves that are being used today. Joann had a pin watch that she used when she taught Sunday School. Otherwise the children kept asking questions about the click.

We had a wonderful dog who would play hide and seek with Joann. She would throw a ball and run to hide. The dog would ALWAYS listen for her clicking heart valves. We were so sad when the dog lost her hearing. It was such fun.

The clicking noise does reduce as the scar tissue forms around the repaired heart.

This should not be your criteria in selecting heart repairs. The new Carbomedics are nearly 100% quiet. Other mgfs. are also very quiet and will not be an issue after a few months. They will mess up your poker skills.

 

[SusanC54]

Hi Sona,
Welcome to VR.com. This site is truly an invaluable source of information.

Ticking.....hmmmm.....yes, I definitely tick but I can say that fifteen months post-op, I think that it is not as loud as it used to be. The day that I came home from the hospital I freaked myself out when I went into our tiled bathroom which seems to have just the right acoustics to enhance the sound! It is also a source of amusement for relatives and friends ....... as my daughter has said to her friends, "This is my mom. She ticks!"

The very prominent heartbeat that was quite noticeable when trying to fall asleep post-op has also gotten better with time. I don't think my husband can really hear me ticking away at night anymore.........

As for Coumadin, it's really no big deal. I self-test, adjust my own medication and really the only complaint I have is my tendency to get some impressive bruises......I've been doing a lot of heavy lifting and packing in preparation for a move across country so I've had some big big bruises! But I will also add that I had a tendency to bruise easily even before my surgery, so it stands to reason that the Coumadin would exacerbate the situation.

Good luck with all your research and I hope that you have a long long wait ahead of you!

Susan

 

[JimL]

Jim,

Did you call or write to St Jude? I would not mind having a valve....one that did not pass inspection. Don't want to buy another one

Tom

The phone number on my St. Jude card is 651-483-2000, although it's a few years old...