Dr. Gooley and co-authors present a prospective, open-label, single-arm study of the Acurate XL Prime valve which is an iteration of the Acurate neo 2 valve currently outside of the US [ ]. The Acurate XL prime is a larger valve extending the annular sizes that can be treated. This is a small study of 13 patients at 3 Australian centers with a mean age of 83.1 years. All patients had successful deployment of the valve and there was no mortality or stroke. One patient required a pacemaker (1/12; 8 %). The mean gradient at discharge was 7.7 mm hg and mean EOA 1.9 cm 2 . Trace or no PVL was seen in 92 % of the patients. Although a very small study, these are excellent results by very experienced implanters. What should this mean to those in the US reading this article?