This study evaluates the safety and effectiveness of cardiopulmonary bypass (CPB) as hemodynamic support during combined high-risk percutaneous coronary intervention (PCI) and transcatheter aortic valve replacement (TAVR). The authors demonstrate that CPB provides stable circulatory support, enabling complete revascularization and valve implantation in complex patients with severe coronary artery disease and aortic stenosis, with acceptable complication rates and favorable procedural outcomes.