Reasons for low complication rates and ease of use of the device have previously been reported: (i) re-sheathability, (ii) top-down implantation technique compressing the native leaflets and capturing them in the waist of the device, hence reducing the risk of paravalvular leakage and potentially also reducing the risk of coronary occlusion, (iii) stabilization arches allowing a coaxial self-alignment of the valve and stent commissure alignment during fluoroscopy, hence avoiding a stent-post in front of the coronary ostia and potentially easing later interventional access to the coronaries, (iv) the upper crown allows supra-annular anchoring, tactile feedback and stable positioning, (v) the waist conforms to the native annulus, (vi) the lower crown allows for minimal stent protrusion into the left ventricle and hence (in combination with the low radial force needed due to the anatomic shape of the valve) reduces the risk of conduction system interference with subsequent pacemaker implantation, and (vii) the PET skirt acts as a seal to prevent PVL [4–6, 9].