Cardiac Rehabilitation after BENTALL Surgery: Case Report with Literature Review

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.