Apologies in advance if I am misunderstanding you, but are you having difficulty with holding a key in and then doing some other kind of SendKeys/SendMouse action? I have provided two examples here, the second I don't really have time to take any further, I will leave that as an exercise for you. 
#!/usr/bin/perl

use Win32::GuiTest qw(:ALL :VK);    

# launch notepad, hold shift, type things
system("start notepad.exe");
sleep 1;

SendRawKey(VK_SHIFT, 0);
SendKeys ("im the operator with my pocket calculator");
SendRawKey(VK_SHIFT, KEYEVENTF_KEYUP);

# Untested, but you may be able to get away with something like this
SendRawKey(VK_ALT, 0);
SendLButtonDown();
SendLButtonUp();
SendLButtonDown();
SendLButtonUp();
SendRawKey(VK_ALT, KEYEVENTF_KEYUP);

[download]
Hope this helps

Martin

In reply to Re: using Win32::GuiTest recreate key and mouse action by marto
in thread using Win32::GuiTest recreate key and mouse action by Kashratul

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