Mechanical Heart Valve Replacement Still Clicking… 27 Years Later

By Adam Pick on November 3, 2008

I just received this interesting email from Margaret. She had mechanical valve replacement surgery almost 27 years ago. I thought you would appreciate her thoughts about surgery and the clicking noise of mechanical heart valves.


I just received your book and so far it’s great. I’m not like most people who is buying this to understand what to expect but to see what has changed.

I’m 39 yrs old and had my aortic valve replaced when I was just 13 years old. Yes, that is correct 13 years old. When I had it done, I was given just a month to live without it. So far, I have yet to speak or hear of anyone with a valve as long as I have.



This March will be my 27th anniversary with the same mechanical valve. I have been told recently that it will need to be replaced within the next 5 years. I always knew that I would need to have it replaced at least once in my life time. Even though I have been through this before I seem to have more fear now that I’m older and understand what is going on.

I have been on blood thinners almost my whole life and just recently found out that you can get a home INR testing machine. I’ve been asking for years about this machine but my doctors told me they are not available to the public yet. After all these years, my arms need a rest from getting blood taken every month.

I’m now currently working with my insurance company to get one. One thing that sticks out for me was after my replacement no one told me about the clicking sound from my valve. For days, I went around my house looking to find that loud clock or watch that was always ticking.

I can remember sitting alone in the bathroom with my drainage tubes attached and wondering, “Where is that noise coming from?” It would have been really nice to know this beforehand. The noise is now second nature to me. Some days I need a pillow against my chest to get to sleep but for the most part its fine.

I have lived a very normal life and even have a 16 year old daughter. The doctor’s told me at the time it was not allowed. Times have changed since March of 1982 and that alone gives me a peace of mind. I do want to share a important fact… Dr. Peak, my surgeon, shared this with me. He said that you will always need to know more than the doctors. I have found this fact to be so true and it’s something I live by. Maybe that’s way I’ve been able to last this long with one valve.

Margaret Reese

Written by Adam Pick
- Patient & Website Founder

Adam Pick, Heart Valve Patient Advocate

Adam Pick is a heart valve patient and author of The Patient's Guide To Heart Valve Surgery. In 2006, Adam founded to educate and empower patients. This award-winning website has helped over 10 million people fight heart valve disease. Adam has been featured by the American Heart Association and Medical News Today.

Adam Pick is a heart valve patient and author of The Patient's Guide To Heart Valve Surgery. In 2006, Adam founded to educate and empower patients. This award-winning website has helped over 10 million people fight heart valve disease. Adam has been featured by the American Heart Association and Medical News Today.

Adrian Bishop says on November 3rd, 2008 at 9:26 pm

Dear Margaret,
Thank you for telling us your adventure. Congratulations on such a ‘normal’ life. I went through my first aortic valve replacement just 4 months ago, and a friend remarked on how calm I was about the whole thing. Sometimes we just gotta do what has to be done.

But, the thought of a second round is daunting. You are already a real veteran; continue your calm centering, and don’t let all the info out here buffalo you.

I am interested that you originally went ‘mechanical’. I went bio, after first advice was to go mechanical, because my surgeon thought that where I lived (nowhere close to a cardiac center) and my life style, could be hazardous if the mechanical failed, whereas a bioprosthetic would fail gradually, just like my birth version.

Also, going bio meant no blood thinners after a while. I have just come off Plavix, and never needed coumadin.

Good luck with your clicker, and with your upcoming choices.

Adrian B

Meigs Matheson says on November 5th, 2008 at 9:53 pm

I could be facing the decision of bio or mechanical miral valve. I have moderate to severe mitral valve regurgitation- I am on hold for any try at reapair at the moment. I was wondering how old you are, and what you mean by your lifesyle- I don’t mean to pry- but I am 61- and am probably in he middle agewise between bio (which for sure I would prefer) and mechanical if the valve cannot be repaired.

Also are there others out there around 61 who have had had to have valves replaced?- What went into your valve choices?

Thanks, Meigs

Rita Oden says on November 6th, 2008 at 6:40 pm

I am so glad you shared with me. My husband had a mechanical valve replacement after an acending aortic anyerism 19 years ago. He was 35 then and is 54 now. He has started having some cardiac symptoms and, because I am worried, I started researching. When I came across your blog I was able to breathe a sign of relief and also have hope for many more years. Thanks again and I wish you many more happy and healthy years. Rita Oden, Salado, Texas

Geoff Matthews says on November 7th, 2008 at 10:52 pm

Read with interest others stories. Here’s mine and any input/suggestions are very welcome. Had first aortic replacement 1979 at age 43 due to congenital stenosis in bicuspid valave. Went porcine route because orifice was already on the small side for mechanical and did not want clicking or Coumiden. Had second in 1991 age 55 so 17 year life span. Again porcine. Now need another and am tending towards St Jude’s Trifecta (bovine pericrdial)still under trial. Operation will also include replcement of aorta and excising area causing a-fib ( have been on coumedin for last 4 years because of minor stroke associated with a-fib, also heve pace maker). Doc says all this will remove need to be on coumedin post op. Thoughts, comments or suggestions?

Margaret says on November 11th, 2008 at 3:45 pm

Thank you to Adrian and all the other that have left such wonderful messages. Adrian had ask why did I go with an Mechanical valve vs. a porcine. Well first it was done at a military hospital and I had a group of doctors that reviewed my case. They said it would be best for me to go with the mechanical since 1. I was still growing into my body (they put one that was larger then my current one was so I can grow into it). 2. At the time pig was only lasting about 5 yrs. I was not down for doing this again at 18yrs of age. As of today I’m doing great and no signs of problems. They have said that I should only have about 3-5 years left but not 100% sure. When and if that day will come I know I will pick the mechanical valve once again. I’m looking at getting the most years with the least amount of replacements. Has for the blood thinner I grew up with it and it’s all I know. Why change now….Take care and god bless everyone. Margaret

Steve Mayer says on November 14th, 2008 at 9:25 pm

Just finished your book and loved it.
I am very interested in hearing from anyone that has had an ON-X aortic valve put it.
If you could post this question I would appreciate it and please tell me how I could start an ON-X thread.

Bev N. says on December 3rd, 2008 at 12:39 am

I had an aortic valve replacement 3 and a half months ago. I have a mechanical valve which both my surgeon and cardiologist recommended because I was told my aorta was small and a mechanical valve would work better. I hear the clicking at night when it is very quiet, and some nights when I cannot sleep, I do take a sleeping pill. I am 64 and in the gray area for deciding which valve. Since both my parents lived into their nineties, I plan to live for many years into the future. I would not want to undergo this surgery again. I have really had a great recovery and feel great. I am a very positive person and have decided I will put up with the clicking since I wake up each morning with a lot of energy. The clicking is a small price to pay.

Larry Peterson says on December 9th, 2008 at 3:43 pm


This is my first and hopefully NOT last contribution to the heart valve blogs. I read your first response and am very proud that you have 27 year “a clicking”. I had my aeortic surgy when I was 24 (1990) and am 18 years the wiser. I had an mechanical bi-leaflet vlalve put in and could be not the happier. My wifw at first could not fathom, not hearing it click. Than as time went on it was good days, crazy days and everything in between. I have been on Coumidin every day and the home INR meter sounds like a great idea. In the last recent months, they have one of these at the clinic and you only need to take about as much blood as an inbsulin meter and no more needles. I do not have any good veins left in either arm and believe me the poor nurses who have to get through the scar tissue are quite relieved now that a finger prick is only needed. I too am up on my 20 year implant warrenty and I cannot get any data from the manufacturing about fatigue cycle failures. I do not want to go through the surgery again, but I guess I would knowing what life will bring. I hope to chime back from time to time. I really have not had any side effects nor any drawbacks from my surgery. The only time I can really remember when the loud clicking caused any detriment was when my first big buck got too close to my deer stand. I was clicking so loud and breathing so heavy that I think I scared it away. God bless there are many of “you/us” out here livin’ normal lives. Every once and a while a person in a quite room will ask about the loud clock….I just giggle to myself and help them try to find it.

Ken Sihota says on February 6th, 2009 at 3:58 pm

I am 60 years oldand HAVING AORTIC VALVE AND AORTA REPLACED ON 12 OF FEB 2009. bUT I AMCONCERNED ABOUT COUMADINE BECAUSE MY GUMS AND HEmorroids bleed once in awhile.if some body can tell me about this coumadine’s effects on body and how hard it is to manage it. please some body let me know as soon as possible. so that i can decide about mechanical or tissue valve

sharon c says on March 30th, 2009 at 5:30 am

dear everyone, im sha 29 from philippines.i had my first mitral valve repair in 1995, i was 16 yrs old then and i am going to have my mitral valve replacement surgery soon. becoz i am afraid to have my surgery, i can’t decide to have it right now. my first was really traumatic for me bcoz of a verry painful procedures and recovery. i am not well explained on what will be the procedures or what types of valve to replace my valve. or what are to expect after the surgery. everything is unclear to me. my doctor not yet explain to me everything. all i know was, i have to undergo mitral valve replacement. he doesn’t gave me any options. i’m just doing some research on the internet about my condition. i’m having complications right now. i have congestive heart failure. i always feel on and off abdominal pain. water retains on my legs or face. i don’t exactly understant my condition. pls help me about this. and if i have to choose what types of valve i want to replace my valve, what would be the best for me?? and what are the risks?? plss answer me as soon as possible. so i can decide to have my surgery soon.

Dan Halpin says on April 29th, 2009 at 8:24 pm

Adrian, I had a mechanical St’ Judes Mtral vlave replaced when i was 46 do too a heart attack i did not know i had until i had a breathing problem i thought, as it turned out i was regurgitating 68% of my blood back into my lungs. i have the click–lol. At first you could here it across the room and my kids made fun of me in a nice way. i told my 7 yoer old i had swallowed a clock. But as time gwent on, i no longer hear it and sometimes i miss it actually. i have to concentrate to hear it. for the people who are afraid of the clicking niose , they will forget about it after time goes on. i had my velve replaced 10 years ago and as far as the valve goes, it is still doing great.

Stephen Waxman says on June 18th, 2009 at 1:21 pm

I received a mechanical valve in November 1988 and this fall my St Jude valve will be 21 years old.I have been told that I will definitely need a replacement (which will be my third operation !!) sometime in the next few years. I have been very healthy and very active and have had very little problem with coumadin therapy. There is of course a constant clicking of the valve which both my wife and I have become accustomed to. The inconveience of the clicking has been far outwayed by the longevity of this valve. My first valve, a calf tissue vlave only lasted 7 years,

Dale says on June 18th, 2009 at 7:35 pm

I will have had my Kay Suzuki discoid valve for nearly 38 years now. I had my first surgery in 1971 when I was 21. Tomorrow, yes tomorrow I will have it replaced at Johns Hopkins along with my aortic root. The anniversary of my first surgery would have been on Sunday, June, 21st.

I guess these mechanical valves don’t last forever, but 38 years is a heck of a long time. I am a very lucky guy

Stephen Waxman says on August 18th, 2009 at 9:41 am

I have lived with a mechanical aortic valve since November 1988.This was my second valve replacement. The first valve (a tissue valve) was implanted in August 1981 but only lasted seven years. Prior to both operations I contacted bacterial endocarditis from dental work. I have been on coumadin now since 1988 and aside from one episode of a bleeding ulcer from a gastro infection I have had no issues and have led a normal and very active life. I golf, teach skiing as a hobby,teach law part-time at two Universities and work full time as a lawyer for the Department of Justice. The issue of a clicking noise is relevant to all of us with mechanical heart valves. Most of us simply get used to the clicking sound although my wife sometimes complaines about it.I agree completely that we must know our bodies and our health better that the Doctors.I have sometimes found that the mediacal profession can take very conservative stands on many issues for vlave patients,For example, I have had some Doctors suggest that I should not be skiing because I take coumadin. My answer to that is that perhaps I should not drive a car because I might be in an accident. It is far more important to keep active. I know that I will need another replacement in a few years but I am very confident that I will recover and continue to lead an active life. Being positive and living life to the fullest with our families is the best medicine for a long and healthy life. I am so fortunate to have had the University of Ottawa Heart Institute in Ottawa Canada to take care of me over the years. This is truly a remarkable insitution.

Matt Wyglendowski says on August 18th, 2009 at 3:56 pm


Thanks for sharing your story, but I think I have you beat and we may have interesting degrees of separation. From your story and follow up comments I assume you had your surgery at Brook Army Medical Center in San Antonio and Dr. James Peake performed the procedure? If this is the case, was Dr. Schukman involved as well? Also, what type of mech valve did you receive?

My brief synopsis (this is the shortened version):

1972 Diagnosed Aortic Stenosis
1973 Open Heart Valvotomy @ Santa Rosa Medical Center (Age 2)
1979 Open Heart Aortic Valve replacement (Bjork Shiley Mech Valave) @ Brooke Army Medical Center with Dr. Peake and Shuckman (Age 8)
1983 Consult @ BAMC with Dr. Shuckman, Air Vac’d to University of Alabama, Birmingham. Open Heart Aortic Valve Replacement St. Jude Mech Valve by Kono technique with Dr Albert Pacifico. (age 12)
2006 Installed St. Jude Pacemaker (age 35)
2009 (Pending birth of my 3rd child/November?) Open Heart Mitral Valve replacement @ Baylor (Age 38)

I’ve been taking coumadin since I was 8 years old which…well honestly sucked being 8yrs old. I had to grow up real quick and give up all the things that an 8 yr old kid wants to do, ie, baseball, football, soccer and well for that matter anything considered actively competitive due to the bruising and bleeding factors from the coumadin. Eh, what doesn’t kill you only makes you stronger right?

Going through school (mainly high school) when it would get real quiet in class (during tests usually) other students would ask “does anyone hear that clicking noise?” I’d smile to myself. The St Jude I have is a dual flap valve and is much louder than the previous single flap valve I had and when it’s real quiet anyone near me can hear it. My wife tells me it helps put her to sleep when she lays her head on my chest 🙂

I’ve seen where you and others in this thread mentioned your valves needing replacement due to wear. I’ve never gotten confirmation from any of my Dr.’s but have never had any concern about it wearing out. I’ve been told the St. Jude (in wear lab tests) is good for about 300 years, hopefully I’ll get to put that to the test personally.

I recently found out that I need another open heart but to replace the mitral valve this time. I remember, I thought it was funny when Dr. Matter said to my wife “Right now Matt goes click, click, click. Do you have a problem if he goes click, clock, click, clock?” Her response was “I don’t care what sound he makes as long as he’s around”.

Anyway, I’d be interested to find out if we had the same Dr. Peake. I spoke to him about a month ago and he’s doing well and living in the DC area.

Bob Collins says on August 20th, 2009 at 8:11 am

I have really enjoyed reading this Blog since finding it a few weeks ago. I had aortic valve replacement on November 22, 1974. I had a blood infection (subacute baterial endocarditis) about eight years prior to the replacement. I was very young and very healthly, and when I went to the University of Alabama at Birmingham, Dr. John Kirkland examined me and told me that my aortic valve had not gotten to the point where it needed replacing. I continued to go to UAB once a year until 1974, at which time Dr. Kirkland said it was time to replace the valve. I had been told that I would be recieving a pig valve, but when I got to the hospital, Dr. Kirkland informed me that he had a new valve that he was very high on. It was the Bjork Shiley Valve, and that is what he used. I was placed on coumadin, and have been taking it ever since. It has not caused any problems, it is just a hassle getting my protime or INR checked every other week. I got a machine whereby I could check my INR at home, but the insurance company decided after a coupple of years that they no longer would pay for the suppplies, so I quit using it. (I have it available if anyone is interested) I was just in the hospital to have a pacemaker implanted, and the doctor did a procedure where they placed a small camera down my throat, and made images of my heart and the mechanical valve. The doctor told me that based on these images, my valve was still in very good condition, no leaks, and it should be good for several more years. I was very happy for this test, and I would reccommend it to anyone who has had a valve for several years. I got used to the ticking after a few months, but at first it really did bother me. Dr. Kirkland told me not to worry as long as I heard the valve ticking, but if I didn’t hear it, then I could start worrying. I have had many experences with my mechanical valve, and I would be happy to share them with anyone. Just email me. Thanks for providing us with this method for discussing “matters of the heart” with other folks. Bob

Amy Durham says on August 20th, 2009 at 11:05 am


I loved reading your story. I am newly diagnosed with a bicuspid valve which has severe leaking so I will soon (within the month)be going in to have that valve replaced. I have a huge mix of emotions as I try and come to grips with what I will soon go through. I feel that the first thing I must figure out is the issue of the what type of valve to have put in. My surgeon thinks I should go with a mechanical valve because I am only 40. The thought of being on coumadin scares me. How hard is it to regulate? What if I cut myself? What is the scare of having levels to high? What if I eat the wrong things? Bleeding internally? Some times I think the internet has way too much info. As you can see I am on overload. It sounds like you have had very little trouble with coumadin. Are my fears unwarranted? It feels like my life as I know will change. Did you have anxieties before you became acclimated to the medicine?

Thank you again for you post it was a source of inspiration to hear how you have thrived and are still going strong so many years later.

Claudette says on October 24th, 2009 at 11:38 am

My husband had an AVR this past January — and he can not get used to the click. I know he probably would never had done this again. He definetely would have had the pig valve and taken the risk of having the surgery again. Will he ever get used to this click? Will the sound ever deminish?

Claudette says on October 24th, 2009 at 11:39 am

My husband had an AVR this past January — and he can not get used to the click. I know he probably would never had done this again. He definetely would have had the pig valve and taken the risk of having the surgery again. Will he ever get used to this click? Will the sound ever deminish?

Paul Klaassen says on October 26th, 2009 at 12:00 am

Hi Claudette, Sorry your husband is having a hard time adapting to his click. I have heard that some people do have trouble with it though most will admit that when they are busy they don’t notice it. It is only when falling asleep or in a quiet room reading that they can hear it. I had a little trouble with mine at first, it kept me awake for a while. Now I make a point to listen for it and find it reassuring. In time your husband will likely feel the same way. With a pig valve it isn’t so much the risk of reoperation as the certainty.

sil carter says on May 28th, 2015 at 12:45 pm

I had a mechanical fitted October 2014 I wasn’t told about the ticking and spent days wondering where the watch was they don’t tell you about that I’ve only just found out and we are now in may 2015

Doug Scholz says on April 12th, 2016 at 1:43 pm

I had my aortic valve replaced a month ago I’m a 31 Yr old male. The clicking drives me crazy and my surgeon told it will go away once my inr was steady. Well after doing a lot of research I come to find out that this is something that I’m going to live with forever. I know I will eventually get used to it. And I’m so grateful for my valve.

Frank Rizzo says on June 7th, 2016 at 8:58 pm

I’m 40 and had undiagnosed BAV. Had AVR a month ago (plus a double bypass thrown in, you know, as a bonus). I did research before (I only had 6 days notice, so I had to work fast!!) and knew there’d be a clicking sound. Still, it’s unsettling at times! I had some irregular beating initially, which was noticeable because I could hear it!!!

Still, I wouldn’t change my decision. To read Margaret’s story is reassuring. 30+ years puts me right in my preferred window of mortality 😂😂…

Veronda says on July 21st, 2016 at 7:47 pm

Hello Margaret, your story was so uplifting, I had to comment. I had single bypass surgery Dec 20, 2015. Because the surgery was an emergency procedure to save my life, I was told after surgery that I had damage to the heart which resulted in a minor leakage. Well this year after having a follow up echo the leakage had become moderate to severe. I asked my doctor for another opinion, at UAB. I met with Dr. Davies and confirmed that I neede to have my mitral and tricipscid valve replaced with a mechanical one. I have done a lot of reading and research since on the valve they will be installing. After hearing your story of 27 years with your valve, it gave me even more peace that it is possible. I am a 49 y/o female with a beautiful daughter getting ready to go to college. My surgery had been scheduled for August 17, 2016. Please keep me n your prayers… Veronda

Veronda says on July 21st, 2016 at 7:53 pm

Wow, what a story…I will remember your story when I go into surgery…thanks for sharing.

Karima Aziz says on November 19th, 2016 at 2:01 pm

how did your surgery go. i my self had valve replacement 2 months ago. so far things are well.

Damar says on September 5th, 2017 at 7:56 pm

I have read almost all of your stories. And found them very inspirational and uplifting. I am planned to have a heart valve replacement in thr next year or sooner. I am waiting for an angiogram first to see if the veins on the heart are being effected, and then will be talkimg to a surgeon. I am at slight more risk with this surgery I have three blocked arteries on my left arm so to a vascular disease called Takayasu. Its very rare up here in Canada. It pretty much is artherities in my arteries. I am the only on in my long long family line to ever get sick or have a heart issue. The leaky heart valve was caused by the diesease they took them 4 years to actually diagnose me properly cuase it was so rare. So in that time I got pretty sick. My left arm gets very tired and I Myself gets very fatigue and tired a lot even if I am not doing anything. So anyway to stop talkomg about this I am thinking of a mechanical valve they have told me I will never have kids and i accepted that a long time ago when I was early 20’s I am now almost 32 and I think the clicking won’t be that bad I do get used to sounds pretty fast. I have no issues falling asleep now tho I sleep a lot and I will have to get get up early if I am going to be on blood thinners, cuase right now I sleep in pretty late. I do have anxiety I deal with so I hope I will be making a good decision. Will be looking more into this its a big decision. Thank you for your time of someone does read this and post and reply if you have more question.

Sarah says on September 12th, 2017 at 11:49 pm

I hope your surgery went well and you are doing well now. Does the valve bother you at all? I had mine in January 2015, it does take some getting used to!

Lauren Smith Ridgway says on December 11th, 2017 at 7:18 pm

Hi! I had my mitral valve replaced with a “ticker” (St. Jude mitral valve) in October 1985 when i was 8! I am 40 now and it’s still in there tickin’!
I do at home INR draws, too. Am on Coumadin. Glad you’re great! Keep in touch. ❤️, Lauren

John Hamaker Jr. says on September 23rd, 2018 at 7:22 pm

how to email you

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