Europe. The present investigation describes a large, singlecenter experience of 136 consecutive CoreValve transfemoral implants.7 The findings from this series demonstrate a marked improvement in patients’ short-term hemodynamics and functional status. Technical improvements in device engineering reduced its size from a 25-French first-generation device to the current 18-French device, with an increase in acute procedural success from 70% to 91%. Operator experience and procedural learning resulted in better outcomes, with a reduction in 30-day major adverse events from 40% to 15%. The patients in this study were elderly (mean age, 81.5 years), had critical aortic stenosis (mean aortic valve area, 0.7 cm 2 ), and had multiple comorbidities, as reflected in the logistic EuroSCORE mortality estimate of 23.1%. The procedural mortality in the last group of 102 patients was a remarkable 0%, with a 30-day mortality of 10.8% and an estimated 1-year survival of 84%. In this group, other in-hospital major adverse events included stroke (2.9%), an increase in paravalvular aortic insufficiency (26%), and the need for a permanent pacemaker (33%). Importantly, the procedure has evolved from one requiring hemodynamic support, with cardiopulmonary bypass, general anesthesia, and surgical cutdown on the femoral artery, to one that can reliably be performed without bypass and with a true percutaneous approach under conscious sedation.