Biradial kissing balloon aortic valvuloplasty as a bridge to transcatheter aortic valve implantation in a morbidly obese patient.

Balloon aortic valvuloplasty (BAV) has been increasingly used to medically optimize patients with severe aortic stenosis prior to surgical or transcatheter aortic valve replacement, as a bridge to palliative therapy, or as palliative therapy. BAV traditionally requires large vascular sheaths to allow for sizable valvuloplasty balloons. Herein, we report a case of a patient who received BAV as a bridge to gastric surgery to facilitate weight loss as a bridge to transcatheter aortic valve replacement. BAV was successfully completed via a biradial approach.