Frequency of Reduced Leaflet Motion After Surgical Aortic Valve Replacement and Transcatheter Aortic Valve Replacement.

This will be a pilot prospective randomized controlled trial.The study will enroll 50 adult
patients scheduled to undergo SAVR and 50 adult patients scheduled to undergo TAVR. Subjects
who satisfy Inclusion/Exclusion Criteria will be approached for informed consent. Those who
give informed consent will be enrolled. After induction of anesthesia, a computer program
will be used to randomize patients to one of the 2 treatment groups.

1. SAVR patients will get either Warfarin or aspirin

2. TAVR patients will get either Warfarin or aspirin.

Patients will be seen at 4-6 weeks postoperatively for Transthoracic ECHO (TTE), 4
dimensional (4D), Multidetector computed tomography (MDCT) scan and review of medical
history. Phone follow up at 6,9 and 12 months post-operatively.

Data from this pilot study will enable us to determine the feasibility of a larger randomized
controlled clinical trial to investigate the phenomenon of reduced leaflet motion/subclinical
valve thrombosis and, possibly, its clinical importance

Inclusion Criteria:

Scheduled for SAVR or TAVR

- Age > 18 years

- Able and willing to give informed consent

- Able and willing to return for follow up

Exclusion Criteria:

- Contraindications to warfarin, Plavix or aspirin

- Pre-existing medical indication for warfarin, Plavix or aspirin

- History of previous cardiac surgery

- History of previous coronary artery stenting

- Requirement for concomitant coronary artery bypass grafting or mitral valve surgery or
surgical treatment of an ascending aortic aneurysm

- Contraindications to contrast-enhanced MDCT including anaphylactic iodine allergy,
uncontrolled atrial fibrillation, renal dysfunction (GFR < 60 ml/min).