The Symetis ACURATE TA and ACURATE neo technology is a novel transcatheter heart valve for treatment of aortic valvular stenosis. This review illustrates the implantation steps, which are designed for an easy and intuitive transapical and transfemoral TAVI procedure. The most important difference to other self-expanding platforms is the top-down deployment with minimal protrusion of the stent towards the left ventricular outflow tract. In addition, the supra-annularly placed porcine leaflets provide very low gradients and the pericardial skirt acts very effectively to seal against paravalvular leaks. This review reports about the hemodynamic features, low rates of paravalvular leaks and very low rates of pacemaker implantation, which have been observed in various registries. Meanwhile more than 3000 patients have been treated worldwide and additional registries are currently under investigation.
