Cardiac Surgery Prehabilitation

Weinkam, S.; Cook, Nathaniel

doi:10.1016/j.cjca.2017.07.474

Cited by 2 publications

(1 citation statement)

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“…Therefore, standard implementation of prehabilitation before mini‐AVR could be considered to improve post‐operative recovery and quality of life, especially in frail and older patients. During this prehabilitation period, the focus can be laid on increasing and optimizing mobility, nutrition and respiratory status of the patient (Weinkam, ).…”

Section: Discussionmentioning

confidence: 99%

The effect of minimally invasive surgical aortic valve replacement on postoperative pulmonary and skeletal muscle function

Boujemaa

Yilmaz

Robic

et al. 2019

Experimental Physiology

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New Findings What is the central question of this study?How does surgical aortic valve replacement affect cardiopulmonary and muscle function during exercise? What is the main finding and its importance?Early after the surgical replacement of the aortic valve a significant decline in pulmonary function was observed, which was followed by a decline in skeletal muscle function in the subsequent weeks of recovery. These date reiterate, despite restoration of aortic valve function, the need for a tailored rehabilitation programme for the respiratory and peripheral muscular system. Abstract Suboptimal post‐operative improvements in functional capacity are often observed after minimally invasive aortic valve replacement (mini‐AVR). It remains to be studied how AVR affects the cardiopulmonary and skeletal muscle function during exercise to explain these clinical observations and to provide a basis for improved/tailored post‐operative rehabilitation. Twenty‐two patients with severe aortic stenosis (AS) (aortic valve area (AVA) <1.0 cm²) were pre‐operatively compared to 22 healthy controls during submaximal constant‐workload endurance‐type exercise for oxygen uptake (V̇normalO2), carbon dioxide output (V̇normalCO2), respiratory gas exchange ratio, expiratory volume (V̇E), ventilatory equivalents for O2 (V̇E/V̇normalO2) and CO2 (V̇E/V̇normalCO2), respiratory rate (RR), tidal volume (Vt), heart rate (HR), oxygen pulse (V̇normalO2/HR), blood lactate, Borg ratings of perceived exertion (RPE) and exercise‐onset V̇normalO2 kinetics. These exercise tests were repeated at 5 and 21 days after AVR surgery (n = 14), along with echocardiographic examinations. Respiratory exchange ratio and ventilatory equivalents (V̇E/V̇normalO2 and V̇E/V̇normalCO2) were significantly elevated, V̇normalO2 and V̇normalO2/HR were significantly lowered, and exercise‐onset V̇normalO2 kinetics were significantly slower in AS patients vs. healthy controls (P < 0.05). Although the AVA was restored by mini‐AVR in AS patients, V̇E/V̇normalO2 and V̇E/V̇normalCO2 further worsened significantly within 5 days after surgery, accompanied by elevations in Borg RPE, V̇E and RR, and lowered Vt. At 21 days after mini‐AVR, exercise‐onset V̇normalO2 kinetics further slowed significantly (P < 0.05). A decline in pulmonary function was observed early after mini‐AVR surgery, which was followed by a decline in skeletal muscle function in the subsequent weeks of recovery. Therefore, a tailored rehabilitation programme should include training modalities for the respiratory and peripheral muscular system.

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Section: Discussionmentioning

confidence: 99%

The effect of minimally invasive surgical aortic valve replacement on postoperative pulmonary and skeletal muscle function

Boujemaa

Yilmaz

Robic

et al. 2019

Experimental Physiology

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Cardiac rehabilitation and its effects on cognition in patients with coronary artery disease and heart failure

Alagiakrishnan

Mah

Gyenes

2018

Expert Review of Cardiovascular Therapy

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Cardiac rehabilitation program is an evidence-based intervention and established model of exercise delivery following myocardial infarction and heart failure. Although it forms an important part of recovery and helps to prevent future events and complications, there has been little focus on its potential cognitive benefits. Areas covered: Coronary artery disease and heart failure are common heart problems associated with significant morbidity and mortality, and cognitive decline is commonly seen in affected individuals. Cognitive impairment may influence patient self-management by reducing medication adherence, rendering patients unable to make lifestyle modifications and causing missed healthcare visits. Cognitive assessment in cardiac rehabilitation as an outcome measure has the potential to improve clinical, functional and behavioral domains as well as help to reduce gaps in the quality of care in these patients. Expert commentary: Limited evidence at present has shown that cardiac rehabilitation and exercise has potential in preventing cognitive decline. Cardiac prehabilitation, a rehabilitation-like program delivered before cardiac surgery, may also play a role in preventing postoperative cognitive dysfunction, but needs future research studies to support it.

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Cardiac Surgery Prehabilitation

Cited by 2 publications

References 0 publications

The effect of minimally invasive surgical aortic valve replacement on postoperative pulmonary and skeletal muscle function

The effect of minimally invasive surgical aortic valve replacement on postoperative pulmonary and skeletal muscle function

Cardiac rehabilitation and its effects on cognition in patients with coronary artery disease and heart failure

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