Single-Stage Computed Tomography Angiography, Percutaneous Coronary Intervention, and Transcatheter Aortic Valve Replacement in an Octogenarian With Femoral Neck Fracture, Non-ST-Elevation Myocardial Infarction, and Severe Aortic Stenosis: A Case Report and Literature Review of Multidisciplinary Approaches

Geriatric femoral neck fractures are associated with high mortality. Early surgery within 48 hours improves survival, whereas delayed arthroplasty is associated with a 41% increase in mortality. Multimorbidity in this population often prolongs preoperative optimization, thereby exacerbating perioperative risk. Current evidence indicates that 5%–10% of patients with hip fractures have concomitant severe aortic stenosis (AS), which independently increases the risk of anesthesia-related complications. Perioperative acute myocardial infarction further increases mortality risk, making cardiac management a critical challenge. The advent of transcatheter aortic valve replacement (TAVR) has revolutionized care paradigms. Nonetheless, this situation requires multidisciplinary consensus on optimizing the fracture-to-surgery interval, antithrombotic bridging strategies, and concomitant coronary revascularization. Here, we present a case of single-stage aorta-coronary computed tomography angiography (CTA), percutaneous coronary intervention (PCI), and TAVR in an octogenarian with femoral neck fracture, severe AS, and non-ST-elevation myocardial infarction (NSTEMI). This pioneering case is accompanied by a systematic review of contemporary management strategies.