• All study participants must meet the following inclusion criteria 1. Severe, calcific aortic stenosis with the following criteria:

‣ Jet velocity ≥4.0 m/s or mean gradient ≥ 40 mmHg OR

⁃ AVA ≤1.0 cm2 or AVA index ≤ 0.6 cm2/m2 Note: Qualifying TTE must be within 90 days prior to randomization

• AND 2. NYHA class ≥ II OR Exercisee test that demonstrates a limited exercise capacity, abnormal blood pressure response, or arrhythmia OR Asymptomatic patients with LVEF \<50%

• The Heart Team agrees that the surgical mortality risk is less than 4% according to STS-PROM. The Heart Team's assessment should include evaluation of overall clinical status and comorbidities that may not be adequately captured by risk calculators such as STS-PROM, in addition to the risk score itself.

• The patient has been informed of the nature of the study, agrees to its provisions and has provided written informed consent as approved by certified review board.