Transvenous Transseptal Concurrent Inoue Balloon Mitral and Aortic Valvuloplasty in an Octogenarian With Severe Aortic and Mitral Stenosis

An octogenarian was admitted because of severe aortic stenosis (AS) and mitral stenosis. He declined surgical double-valve replacement and underwent intracardiac echocardiography–guided transseptal puncture and concurrent Inoue (Toray, Tokyo, Japan) balloon aortic valvuloplasty (BAV) and balloon mitral valvuloplasty (BMV). Nine months later, he had worsening pulmonary edema and received a second session of Inoue BAV and BMV. Our case shows that concurrent transseptal Inoue BAV and BMV can treat severe AS and mitral stenosis with adequate safety and efficacy. However, the durability is limited in elderly persons with calcified AS. The procedure should be reserved for patients who refuse surgery.