The real-world SAVI registries with 500 enrolled patients show very good safety and performance outcomes in patients treated with the ACURATE TATM system. Outcomes across the SAVI-1 and SAVI-2 registries and the ‘TA90’ First-in-man and pilot studies are consistent, e.g. moderate or severe PVL <3.5%, ∼10% permanent pacemaker implantation, and ∼20% 1-year mortality [3, 5]. This is remarkable as the ‘TA 90’ cohort were first-time users, as well as approximately 70% of centres in SAVI-1 [6], and speaks for the ease of use of the device. There was a difference in the rate of conversion to open heart between SAVI-1 and -2, though. This could have been a coincidental finding, but could also reflect the fact that, in general, complication management had improved. Similarly, during the same time period, the GARY registry observed an improvement in technical procedural complications [8]. Notably, the number of valve-in-valve procedures was higher in SAVI-2 (2.4% vs 0.8%)—eventually, patients who would have been converted in the early experience had received a valve-in-valve procedure in SAVI-2. Furthermore, the difference between SAVI-1 and -2 observed for rapid pacing probably reflects the increasing confidence in this technique.