Inclusion Criteria:  Aortic valve area (AVA) < 1.0 cm2 (or indexed AVA <0.6 cm2/m2) OR mean gradient > 40 mmHg, OR max aortic velocity > 4.0 m/sec High risk for SAVR defined as STS-PROM score ≥ 8% AND ≤ 15%, OR documented Heart Team agreement of high risk for AVR due to frailty or comorbidities Symptoms of aortic stenosis and NYHA ≥ II  Exclusion Criteria:  Age is less than 65 years old Non-calcified aortic valve Bicuspid aortic valve with no raphe or 2 raphes (Sievers classification type 0 or type 2) Ascending aortic diameter > 4.5 cm