Study device The ACURATE TATM valve has been previously described [4, 5]. In brief, it is a self-expanding nitinol prosthesis with porcine leaflets. Stabilizer arches serve to orientate the prosthesis within the ascending aorta during the deployment phase and avoid its tilting. The diabolo-shape facilitates self-alignment and self-centering of the prosthesis, and a PET skirt contributes to preventing paravalvular leaks (PVL). The prosthesis is available in three different sizes, S, M and L. The delivery system has a crossing profile of 33 F. Commissures of the prosthesis can be placed adjacent to the patients commissure and thus the valve is placed in a truely anatomical manner.