Article

Transcatheter aortic valve implantation plays a leading role in the management of aortic stenosis in patients with comorbidities but no data are
available about cardiac rehabilitation in these subjects. This study aimed to
compare safety and efficacy of an early, exercise-based, cardiac rehabilitation
programme in octogenarians after a traditional surgical aortic valve replacement
versus transcatheter aortic valve implantation.
METHODS: Seventy-eight
consecutive transcatheter aortic valve implantation patients were studied in
order to evaluate the effect of an exercise-based cardiac rehabilitation
programme in comparison to 80 of a similar age having surgical aortic valve
replacement. Functional capacity was assessed by a 6 min walking test on
admission and at the end of the programme. When possible, a cardiopulmonary
exercise test was also performed before discharge. RESULTS: The two groups were
similar in terms of gender and length of stay in cardiac rehabilitation; as
expected, the transcatheter aortic valve implantation group had more
comorbidities but no major complications occurred in either group during
rehabilitation. All patients enhanced autonomy and mobility and were able to walk
at least with the assistance of a stick. In those patients who were able to
perform the 6 min walking test, the distance walked at discharge did not
significantly differ between the groups (272.7 +/- 108 vs. 294.2 +/- 101 m, p =
0.42), neither did the exercise capacity assessed by cardiopulmonary exercise
test (peak-VO2 12.5 +/- 3.6 vs. 13.9 +/- 2.7 ml/kg/min, p = 0.16). CONCLUSIONS:
Cardiac rehabilitation is feasible, safe and effective in octogenarian patients
after transcatheter aortic valve implantation as well as after traditional surgery. An early cardiac rehabilitation programme enhances independence,
mobility and functional capacity and should be highly encouraged.
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Langue : ANGLAIS