Concomitant balloon mitral and tricuspid valvuloplasty using a single Sym balloon

A 31-year-old male with severe rheumatic mitral and tricuspid stenosis presented with NYHA class III dyspnea and pedal edema. Echocardiography confirmed severe mitral (MVA: 0.7 cm 2 , MVG: 8.5 mmHg) and tricuspid stenosis (TVG: 5 mmHg). He underwent sequential balloon mitral and tricuspid valvuloplasty using a single Sym balloon following which the MVG reduced to 5.5 mmHg, MVA increased to 1.3 cm 2 , and TVG reduced to 3.5 mmHg. The patient had significant symptomatic improvement and remained clinically stable at one-month follow-up. This case discusses the considerations for planning, feasibility and efficacy of concurrent balloon valvuloplasty in appropriately selected patients.