The influence of mechanical valve noise on quality of life:

H. Koertke, R. Koerfer Heart Center Northrhine Westfalia, Bad Oeynhausen, Clinic for Thorax and Cardiovascular Surgery, clinic of the Ruhr University Bochum, Germany
Heart valve replacement are the second most common procedure in cardiac surgery. This report analyzes the influence of valve noise from different types (bileaflet versus tilting disk) on the quality of life (QOL).

A total of 1155 patients were enrolled and they received randomly one of the three different valves. St. Jude (bileaflets), CarboMedics (bileaflets) and Medtronic (tilting disk).
Patients were asked: „Have you recently felt impaired by heart valve noise?“ and additionally they completed the SF-36 QOL-questionnaire. The SF-36 was used to evaluate patients‘ QOL to see these criteria were related to patients‘ perception of valve noise.

The majority of patients felt they were not significantly impaired by valve noise. The number who felt significantly impaired at six months (10,6 %) fell to 5,7 by 24 months. We observed, that these patients have valve specific differences after 6 months. After 12 months and 24 months these differences disappeared. Evulation of gender differences indicated an increased perception of valve noise by female patients (p=0,0001).

The results of the 36SF-questionnaire indicate that patients who have a lower level of QOL are likely to be moderately or extremely disturbed by the noise of their valve.

1. Patients‘ perceptions of beingimpaired by the noise of their prosthetic valves might be influenced by four factors:
a) female gender
b) young age
c) impairement of social contacts
d) negative perception of one’s own state of health