Cardiac Rehabilitation after BENTALL Surgery: Case Report with Literature Review
M. Rahmi *
Cardiology Department, International University Hospital Cheikh Khalifa, Morocco.
F. Merzouk
Cardiology Department, International University Hospital Cheikh Khalifa, Morocco.
A. El Ouarradi
Cardiology Department, International University Hospital Cheikh Khalifa, Morocco.
R. Habbal
Cardiology Department, International University Hospital Cheikh Khalifa, Morocco.
*Author to whom correspondence should be addressed.
Abstract
Background: Cardiac rehabilitation is designed to improve cardiovascular health in patients with cardiovascular diseases and is recommended by guidelines as Class IA. In cardiac surgery, cardiac rehabilitation is associated with a lower 2-year mortality. The aim of the present editorial is to highlight the role of cardiac rehabilitation in cardiac surgery in improving cardiorespiratory performance in this patient profile
Methods: We report the case of a 65-year-old male patient, a weaned ex smoker with intercostal herpes zoster treated 5 years ago, who underwent BENTALL surgery for degenerative aortic disease with severe aortic insufficiency, moderate aortic narrowing and aneurysmal dilatation of the ascending aorta with placement of a Dacron tube and replacement of the aortic valve with a biological prosthesis. the patient was recruited 4 weeks post-operatively for cardiovascular rehabilitation, the program included 20 sessions at a rate of 3 sessions per week. started gently with muscle-strengthening sessions emphasizing the inspiratory and peripheral muscles and progressive physical training ‘interval training’ which began with a low load of 5 watts for 40min the first session until reaching 75watts at the end of the 20th session. We noted an improvement in cardiorespiratory capacity. VO2max increased from 11.8ml/kg/min to 14.7ml/kg/min, i.e. 62% of the predicted value, maximum Fc from 120bpm to 113bpm and VE/VCO ratio from 31 to 27 at the end of the sessions. Control LVEF was 48% comparing to 30% initially, and even on quality of life, lifestyle, assessment of cardiovascular risk factors and therapeutic optimization.
Conclusion: In every rehabilitation department, patients following heart surgery—particularly the group described following a Bentall type surgery—make up a minority. Thus, in order to create a collaborative program of further scientific research for this patient population, rehabilitation centers must work together more closely.
Keywords: Cardiac rehabilitation, cardiac surgery, Bentall, cardiopulmonary exercise testing, early mobilization, treatment