Prospective randomized study to determine the clinical outcomes of tissue and mechanical aortic valve replacement in patients aged 55-70yrs.

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In this study, we will seek whether there is any difference in valve related complications (MAPE: major adverse postoperative events i.e. reoperation, endocarditis, major bleeding or thromboembolism ) and short/long term survival between patients receiving tissue vs mechanical valves. It will be a prospective randomized study using the two most commonly used valves - St Jude Mechanical (St Jude Medical) and Mosaic tissue (Medtronic). Patients requiring aortic valve replacement who give consent will be randomized to either having tissue or mechanical valves. They will undergo echocardiogram and quality of life measures at baseline. They will be followed up during their stay in hospital and periodically thereafter to gather data to obtain the information described below. They will receive an echocardiogram at 6 months, 24 months and ever 24 months thereafter until the end of follow up (up to ten years). They will also receive telephone interview six monthly but the research assistants and yearly by the clinicians. Data will be gathered to identify the following: 1] Predictors of early and late mortality 2] Long term survival 2] Freedom from reoperation 3] Freedom from TIA, stroke and thromboembolic episodes 4] Freedom from endocarditis 5] Freedom from hemorrhagic complications 6] Freedom from hospitalization 7] Rate of readmission 8] Freedom from valve failure

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