Balloon mitral valvuloplasty and transfemoral transcatheter aortic valve replacement for rheumatic mitral stenosis with aortic stenosis

We present a case of combined balloon mitral valvuloplasty followed by transfemoral transcatheter aortic valve replacement in a high surgical-risk patient with rheumatic mitral and aortic stenosis. Careful anatomical assessment and procedural sequencing can enable safe transcatheter management in selected patients with rheumatic multivalvular disease.