The goal of this clinical trial is to determine whether a non-invasive coronary assessment strategy using photon-counting detector computed tomography (PCD-CT) is non-inferior to invasive coronary angiography (ICA) for evaluating coronary artery disease (CAD) prior to transcatheter aortic valve replacement (TAVR) in patients with severe aortic stenosis.
Age ≥ 18 years
Severe aortic valve stenosis and indication for intervention according to current European Society of Cardiology (ESC) guidelines
TAVR candidate
Written informed consent
Cardiogenic shock at presentation (e.g., emergency indication for TAVR)
Severe renal impairment with an estimated glomerular filtration rate of <30 mL/min/1.73 m²
Life expectancy <1 year due to other severe non-cardiac disease (e.g., malignancy)
Pregnancy