Management of older adults with severe aortic stenosis and indication of non-cardiac surgery for colorectal neoplasm: What do we treat first?

Severe aortic stenosis may increase risks and pose limitations in non-cardiac surgeries, sometimes requiring prior treatment. Surgery for colorectal neoplasms is frequently the priority indicated treatment as its delay can increase the risk of developing complications (e.g. bowel obstruction). The coexistence of both conditions in older comorbid patients may be challenging during the decision-making process. In this case series, four cases of older adults with severe aortic stenosis and colorectal neoplasms with surgical indication are presented. A description of the management of each case, with a revision of the current cardiovascular risk assessment guidelines, is done.