Bicuspid Aortic Valve Replacement: Evaluation of Transcatheter Versus Surgery-Pilot Trial

Inclusion Criteria: * Provision of signed and dated informed consent form * Stated willingness to comply with all study procedures and availability for the duration of the study * Male or female, aged \> 50 years of age * Site-determined severe AS deemed necessary for treatment with SAVR or TAVR * Gated contrast CT available and suitable for core laboratory analysis * BAV anatomy confirmed by CT core laboratory analysis Exclusion Criteria: * Recent cardiovascular intervention within the prior 30 days. * Presence of an existing TAVR or SAVR device * Pregnancy or lactation * Extreme or prohibitive TAVR or SAVR risk, determined by site or committee Active enrollment in another investigational study * Disproportionate TAVR vs SAVR risk, as determined by treating site or committee * Associated aortopathy (AA≥ 45 mm by maximal cross-sectional dimension, as confirmed by CT core laboratory analysis, or AA\<45 mm but site plan for surgery of the aorta in the event of randomization to surgery * Site plan for treatment of concomitant non-coronary cardiovascular disease in the event of randomization to surgery (for instance, concomitant valve surgery, septal defect or coarctation repair, aorta or root replacement or repair) * In the presence of coronary artery disease deemed necessary for revascularization in the event of randomization to SAVR or TAVR, Syntax score ≥ 32 or deemed unsuitable for PCI, or deemed unsuitable for coronary artery bypass grafting (CABG).