Periprocedural hemodynamic stability is the cornerstone of success for complex percutaneous interventions. Percutaneous left ventricular assist devices (VSD) are increasingly being used to perform complex percutaneous coronary and non-coronary interventions. We report our experience in utilizing the TandemHeart, a percutaneous VSD, to successfully perform complex tandem procedures; balloon aortic valvuloplasty and angioplasty.