RanDOmized stUdy Comparing Both Latest Generation Self-Expanding Valves and a Minimalist approaCH vs. Standard Of Care In transCathEter Aortic Valve Implantation

Inclusion Criteria:

• Severe symptomatic aortic valve stenosis (AVA ≤1 cm² or 0.6 cm²/m²) with indicationfor transcatheter aortic valve implantation according to heart team consensus

• Perimeter-derived native aortic valve annulus diameter measuring 21-27 mm

• Heart team consensus that the patient is anatomically suitable for both device types

• Suitability for transfemoral vascular access

• Written informed consent

Exclusion Criteria:

• Life expectancy <12 months due to comorbidities

• Native aortic valve annulus <21 mm and >27 mm

• Bicuspid aortic valve

• Cardiogenic shock or hemodynamic instability

• Active endocarditis

• Contraindications for transfemoral access

• Active peptic ulcer or upper gastro-intestinal bleeding <2 weeks

• Hypersensitivity or contraindication to aspirin, heparin or clopidogrel

• Contraindication for minimalist approach

• Clear patient-specific clinical or anatomic reasons to prefer one approach or valvetype over the other

• Active infection requiring antibiotic treatment

• Age <18 years

• Participation in another interventional trial where the primary endpoint has notbeen reached