Cardiac Rehabilitation After Heart Valve Surgery COMPARISON WITH CORONARY ARTERY BYPASS GRAFT PATIENTS

PURPOSE: Coronary artery bypass graft (CABG) surgery patients participating in cardiac rehabilitation (CR) experience improvements in aerobic fitness, but there has been little study of outcomes for heart valve (HV) surgical patients. The primary aims of this study were to evaluate baseline peak aerobic capacity for HV patients participating in CR and to compare outcomes between HV and CABG patients. METHODS: Five hundred seventy-six consecutive patients who underwent HV surgery (n = 125), HV plus CABG surgery (n = 57), or CABG surgery (n = 394), all with classic sternotomy and enrolled in CR, were prospectively studied. Changes in outcomes were assessed for individuals who completed CR (n = 313). RESULTS: HV patients were significantly older and had a greater percentage of females than the CABG-only group. Combining HV and HV + CABG groups, valvular disorders included 134 mitral, 39 aortic, and 8 combined abnormalities (mitral and aortic). For the entire cohort, the mean number of CR exercise sessions attended was 23.6 +/- 11.7. Peak oxygen uptake ((V)over dotO(2)) increased 19.5% from 17.4 +/- 4.4 to 20.8 +/- 5.5 mLO(2).kg(-1).min(-1) (P < .0001). Improvement in peak (V)over dotO(2) with CR exercise training was similar between the 3 groups of patients. Within the group of patients who had HV surgery, percentage change in peak (V)over dotO(2) was not significantly different between the 3 types of valvular abnormalities (ie, mitral [19.2%], aortic [24.4%], and mitral + aortic [21.9%]). CONCLUSIONS: HV surgery patients achieve similar improvement in aerobic fitness from participating in CR exercise training as individuals who had CABG. The observed improvements in aerobic fitness are similar, regardless of the type of valve abnormality or whether CABG was performed concurrently.