A prosthetic heart valve delivery system comprising a balloon catheter system and a balloon-expandable heart valve , the balloon catheter system comprising: a balloon catheter having a balloon on a distal end in fluid communication with an inflation lumen extending through the balloon catheter , the balloon-expandable heart valve crimped onto the balloon ; characterized in that it comprises an integrated inflation subsystem comprising: a manifold having internal passages; an inflation port; a vacuum port; a balloon port, the balloon port in the manifold connected to a proximal end of the balloon catheter and in fluid communication with the inflation lumen of the balloon catheter ; and a control valve ; a pressurized vessel integrated with the inflation port in the manifold ; and a vacuum vessel integrated with the vacuum port in the manifold ; wherein the control valve on the manifold is configured to selectively open and close fluid communication between the balloon port and the inflation port so that a positive pressure differential from the pressurized vessel inflates the balloon, and to selectively open and close fluid communication between the balloon port and the vacuum port so that a negative pressure differential from the vacuum vessel deflates the balloon . a balloon catheter having a balloon on a distal end in fluid communication with an inflation lumen extending through the balloon catheter , the balloon-expandable heart valve crimped onto the balloon ; characterized in that it comprises an integrated inflation subsystem comprising: a manifold having internal passages; an inflation port; a vacuum port; a balloon port, the balloon port in the manifold connected to a proximal end of the balloon catheter and in fluid communication with the inflation lumen of the balloon catheter ; and a control valve ; a pressurized vessel integrated with the inflation port in the manifold ; and a vacuum vessel integrated with the vacuum port in the manifold ; wherein the control valve on the manifold is configured to selectively open and close fluid communication between the balloon port and the inflation port so that a positive pressure differential from the pressurized vessel inflates the balloon, and to selectively open and close fluid communication between the balloon port and the vacuum port so that a negative pressure differential from the vacuum vessel deflates the balloon . a manifold having internal passages; an inflation port; a vacuum port; a balloon port, the balloon port in the manifold connected to a proximal end of the balloon catheter and in fluid communication with the inflation lumen of the balloon catheter ; and a control valve ; internal passages; an inflation port; a vacuum port; a balloon port, the balloon port in the manifold connected to a proximal end of the balloon catheter and in fluid communication with the inflation lumen of the balloon catheter ; and a control valve ; a pressurized vessel integrated with the inflation port in the manifold ; and a vacuum vessel integrated with the vacuum port in the manifold ; wherein the control valve on the manifold is configured to selectively open and close fluid communication between the balloon port and the inflation port so that a positive pressure differential from the pressurized vessel inflates the balloon, and to selectively open and close fluid communication between the balloon port and the vacuum port so that a negative pressure differential from the vacuum vessel deflates the balloon . <EOS>