It is unclear, what the best therapeutic strategy in patients with symptomatic aortic valve stenosis at intermediate risk of perioperative mortality is. While surgical aortic valve replacement (SAVR) is still considered standard of care in low to intermediate risk patients, minimal-invasive transcatheter aortic valve implantation (TAVI) has been shown to be safe and effective in patients deemed inoperable or at high risk of perioperative mortality. Meanwhile, a paradigm-shift in TAVI from inoperable and high-risk towards intermediate risk patients has already begun, despite of lacking evidence in this field.