Mechanical v Bio Mitral Valve - British Heart Fou...

British Heart Foundation
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Mechanical v Bio Mitral Valve


My partner is having to make the decision. She is being put off the mechanical from the potential noise it will make which will drive her mad and also being on Warfarin for the rest of her life. This is against the bio which will have to be repeated in 10 years or so as she is only 48.

It would be great to hear anyone's real life experiences with a mechanical mitral valve (noisey or not?), life on Warfarin and living with the thought of having to have a 2nd valve replacement some time in the future if you chose a bio valve. And how and why people made the decision of one type of valve versus the other. Thanks

18 Replies

I had a mechanical valve fitted last November after my first AVR with a tissue valve started leaking a couple of years after the surgery. The only time I hear the clicking is when it is very quiet, usually at night, and even then it isn’t that loud. I actually find it quite soothing. My husband still hasn’t heard it at all and my cats don’t stare at me wondering where the noise is coming from 😺 Certainly someone standing next to me wouldn’t be able to hear it.

As far as the warfarin is concerned, my clinic supports home testing, which means I don’t have to keep taking time off work to attend the clinic. I had to buy the machine, lancets and testing strips myself but some GP surgeries do prescribe the test strips. I just do the test, phone the reading through to the clinic and the nurses let me know what dose to take. I can also ring them any time if I have any problems/questions. I’m lucky because my INR levels stabilised very quickly, but you need to read up on what foods affect warfarin. Also make sure you check with the pharmacist if buying over the counter medicines to make sure they don’t conflict with warfarin.

It is also worth asking the surgeon about a new valve on the market which apparently lasts a lot longer than the present tissue valves, can’t remember the name but I’m sure someone on here will know it. Not all heart centres are using it yet, but I know Glenfields in Leicester are. There is also the possibility of being able to have repeat surgeries done by keyhole surgery so less invasive. Unfortunately I wasn’t suitable for either so it was a second open heart surgery.

Hope this helps.


Hi iv had 2 mitral valve replacements and I can say that my first was noisy (st judes bi leaflet) 2011 but I got used to it along with the warfarin I now do my own inr tests so no need to go to appointments constantly, now my 2nd Mitral valve replacement was this year in may the 26th at papworth,my first was also at papworth (Amazing place) I must add, now this time I had a another “mechanical” valve but this time it was from a company called Medtronic this was also a bi leaflet but this one was so quiet I could barely hear it unlike the st Jude’s.

But it’s up to you keep researching and asking questions and you will soon find your answer, hope this made sense, if you want to ask me anything about what to expect please do so.

I had an aortic valve replacement in Nov 1989 . I am now 61 years old. I was 32 at the time with a young family. I was born with a faulty valve. I have a titanium valve. I have had no problems. I don't hear it all except possibly at night time and it can sometimes sound like a ticking clock but, this rarely happens. I have been on warfarin since then, get regular checks and no problems. I had the same choice but didn't fancy having to endure a second operation in ten years time. If I had I would be now planning a third op so I am glad I have the titanium valve.


This link should give you details of the new long life Edwards tissue valve, just been given FDA approval in the US and currently being fitted in a number of UK hospitals:

MichaelJHHeart Star
in reply to IanGordon

I hope I am wrong (I am very occasionally) but I suspect that the new long life tissue valve is only available as an aortic valve currently.

in reply to MichaelJH

Oops - You're correct, Michael. Aortic valve.

MichaelJHHeart Star

If your wife does sports that carry the risk of bruising then a tissue valve with the expectation of a redo in ten years. If not, and after ten, mechanical. Redos carry more risk as you age

My husband had his aortic valve replaced with a mechanical one 7 years ago. Sometimes you can hear it as everyone else says but I call it his "healthy heart click"... It's kind of reassuring for us both.. Read up on warfarin and ask any questions you may have for peace of mind. 😉

My Heart Story (or How I came to this site)

Oct 2015 (age 57) Underwent a pre-emptive double by-pass and AVR replacement Prior to this had three angiograms to monitor BP symptoms AVR is a titanium ON-X valve

. The op took place four weeks after the last angiogram review

A tissue valve was not a viable option as it would present a risk in creating difficulty in replacing it over time. Interfering with the double by-pass etc. to replace.

My own consideration was the future of the NHS with waiting times for any replacement work required, if a bovine valve, would be.

With the effect of such on both my heart, body and lifestyle needing to be considered. What would my lifestyle be if they experienced difficulty in any future ops!

Warfarin took a while to get settled readings but is now okay, the ON-X requires lower Warfarin reading than other valves. I am on 4mg with an INR of 1.5 (which is the valve requirement)

The noise is only noticeable in a silent room and is the sound of a good quality watch. People comment that they almost have to have their ear touching my chest to hear it! Yes, it was loud just after the op, however, it lessened considerably as my chest wound recovered.

Also, now, the thought of going through future operations is very unpleasant so I am grateful that this is a "one-off" and a op free lifestyle and life is one that I am so grateful to have.

Hope this helps

Take care and all the best

I had a mechanical aortic valve replacement 6 weeks ago. I have to be honest and say that the clicking in the night is driving me mad!! It's very loud 😡 but others say I will get used to it. I am 57 and chose mechanical as I don't want to face surgery again. I am on Warfarin and so far it is not causing any issues for me. Good luck

in reply to Gill1026

Hi Gill,

It will get a lot quieter as healing progresses

I have a bio and yes it has had to be redone but it’s worth it

Yes I had a titanium valve as a replacement and I like the others don’t mind the ticking and in fact strangely reassuring it’s pretty quiet anyway

I had to make the decision in two days and kept going over it and over it and was drawn to the natural tissue but couldn’t bear the thought of having another op and I wasn’t given the option of the Edwards valve so although initially very nervous about warfarin I go to the nurse once a month and get my print out for the next month so it’s ok x

Hi, I had to choose in 2015. I went for a mechanical valve. I think the worst part is having your breastbone cut and the length of time it takes to heal.So the thought of going through that again is why i opted for a mechanical valve. I find if i lie on one side in bed i can hear it ticking.In day time you dont hear it.The warfarin is okay i have it tested regularly

in reply to Rupertthedog

Yes you are so right the sternum has taken along time to heal and the scar is still sore on times then lying on your back for ages and not being able to turn over but finally getting there now x

Thank you all so much for your replies. She had successful surgery yesterday with a bio valve. It was a very hard choice but for someone who can't sleep if there is even a clock in the room she decided to go down that route. Hopefully in 10 or so years time when it comes to the next one, mitral valve repair technology and procedures will have progressed to non open heart being the norm. I hope this thread in some small way helps others in the same situation.

Oh so glad it went well

Yes technology is moving so fast so there’s a good chance that will happen

Take of yourselves x

MichaelJHHeart Star

Glad to hear it went well. They are already doing some mitral valve surgery by keyhole surgery so itay be that the replacement is possible that way in ten or so years. However, forget that for now and start to focus on recovery as that will be enough to concentrate on.

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