title: Heart valve sound of various mechanical composite grafts, and the impact on patients' quality of life.
abstract: OBJECTIVE
  The closing sounds of mechanical heart valves can be disturbing for patients and their closest relatives. Although some investigations into mechanical heart valve sounds have been performed, the particularities of the valve sound when it is attached to a vascular prosthesis to replace the aortic root and the ascending aorta has not been studied to date. The study aim was to compare the closing sounds of three various mechanical composite graft prostheses, and to analyze the impact of such sounds on the patients' quality of life.
  
  
  METHODS
  Thirty patients who had undergone aortic root replacement were prospectively randomized into three groups, receiving either a Sorin, St. Jude Medical (SJM) or ATS mechanical composite graft. Valve sounds were recorded with microphones, and sound pressures at peak measured at three months after operation. Patients were interviewed at three and six months after surgery to assess subjective disturbance, using both an analog scale from 1 to 10 and a more detailed questionnaire.
  
  
  RESULTS
  Sound pressures at peak tended to be lower for the ATS than for the SJM and Sorin composite grafts (44.4 +/- 3.1 dB versus 47.8 +/- 3.1 dB and 46.6 +/- 6.0 dB; p = NS). The overall subjective disturbance with ATS valves scored significantly lower than the SJM and Sorin composite grafts (2.5 +/- 1.6 versus 4.1 +/- 1.7 and 4.6 +/- 2.2; p<0.05 after three months; and 2.6 +/- 1.2 versus 4.4 +/- 2.3 and 4.4 +/- 3.3; p<0.05 after six months). Scores for disturbance during daily activities, sleep disturbance and audibility to relatives were lowest for the ATS composite grafts.
  
  
  CONCLUSIONS
  The sound pressure of ATS composite grafts was slightly (p = NS) lower than that of SJM and Sorin composite grafts. Patients who received an ATS composite graft were significantly less disturbed by the valve noise than those with SJM and Sorin composite grafts.
authors.affiliation: Department of Cardiovascular Surgery, University Hospital Berne, Switzerland.
authors.forename: Karl
authors.initials: K
authors.lastname: Golczyk
authors.forename: Martin
authors.initials: M
authors.lastname: Kompis
authors.forename: Lars
authors.initials: L
authors.lastname: Englberger
authors.forename: Thierry P
authors.initials: TP
authors.lastname: Carrel
authors.forename: Mario
authors.initials: M
authors.lastname: Stalder
mesh_terms: D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000601:surgery*; D005260:Female; D006347:Heart Sounds; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D055815:Young Adult