Transcatheter aortic valve implantation (TAVI) has revolutionized treatment of symptomatic severe aortic stenosis (AS). Noninferiority or superiority of TAVI compared with surgical aortic valve replacement (SAVR) in 2 randomized clinical trials (RCTs) in low-risk patients1,2 led to US Food and Drug Administration approval of TAVI in August 2019 to include all surgical risk levels. Current guidelines no longer recommend using SAVR risk alone in deciding between TAVI vs SAVR and instead focus on expected patient longevity, physiologic risk of SAVR, anatomic risks of TAVI, and patient wishes. This change led to TAVI becoming more common than SAVR.3 Data from the Vizient Database for 2015 to 2021 show that among 17 487 patients younger than 65 years, TAVI use increased 2.7-fold such that in 2021, 47.5% of cases were TAVI and 52.5% were SAVR.4