Regarding valve design, there could be a concern that the two-step deployment and the higher need for post-dilatation compared to balloon-expanding valves [10] might lead to a higher stroke rate. With the limitation of site-reported data and the lack of differentiation between minor and major stroke, we did not observe a high stroke rate in the SAVI-registries. This observation is confirmed by a transcranial doppler ultrasound study, comparing the frequency and pattern of high-intensity transient signals (HITs) in 22 patients receiving either the transapical ACURATE TATM or the balloon-expandable SAPIEN XT valve (Edwards Lifesciences LLC, Irvine, CA, USA), which found similar outcomes for both devices [11].