Cardiac Rehabilitation Following Thoracic Aortic Dissection Surgery: A Multi-Center Retrospective Study
Abstract Body (Do not enter title and authors here): Background: Despite expert opinion recommending patient-tailored cardiac rehabilitation (CR) after acute aortic dissection, both patient participation in CR and the associated risk factor modification after CR following aortic dissection repair are poorly understood. Objectives: To describe the characteristics of patients referred to CR, as well as the enrollment rate and outcomes of those referred to CR following thoracic aortic dissection. Methods: We reviewed electronic health records of adults (≥18) discharged alive following thoracic aortic dissection surgery across the Mayo Clinic Enterprise (01/01/2020-11/15/2022) with follow-up to 05/15/2024 (IRB #24-001141). Data are presented using summary statistics. Results: During the study period, 85 patients were included (median [IQR] age: 65 [50-75] years; 40% female; Table 1). Across 84% (N=71) who were referred to CR at discharge, 55% (N=39) enrolled. In those patients referred versus not referred to CR, the prevalence of type A dissection (75% vs. 43%), end-organ involvement (27% vs. 0%), and underlying CAD (54% vs. 21%) were greater while current tobacco use (9% vs. 29%) was lower. Of those enrolled at Mayo Clinic (N=16), CR was started 35 (28-65) days following surgery. These patients completed 21 (13-30) CR sessions at an exercise intensity of 59% (50-65%) maximum predicted heart rate. CR was discontinued in 44% (N=7) due to non-cardiac reasons (Table 2). Of the 9 patients who completed CR, general health status (Dartmouth index: 19 [17-21] vs. 26 [22-34]), depressive symptoms (PHQ-9: 1 [0-1] vs. 4 [1-4]), and exercise capacity (6MWT: 214 [196-244] vs. 384 [305-597] meters) improved (Table 2). There were no reported complications or deaths, with stable aortic sizes reported at 18 months. Conclusions: CR improves functional capacity and well-being without complications in patients after thoracic aortic dissection surgery. Further investigation is needed to better assess CR efficacy and usage in this population.
Heybati, Kiyan
( Mayo Clinic
, Jacksonville
, Florida
, United States
)
Shapiro, Brian
( Mayo Clinic
, Jacksonville
, Florida
, United States
)
Ochal, Domenic
( Mayo Clinic
, Jacksonville
, Florida
, United States
)
Poudel, Keshav
( Mayo Clinic
, Jacksonville
, Florida
, United States
)
Zuberi, Eric
( Mayo Clinic
, Jacksonville
, Florida
, United States
)
Tayon, Kevin
( Mayo Clinic
, Jacksonville
, Florida
, United States
)
Dineen, Elizabeth
( Mayo Clinic
, Jacksonville
, Florida
, United States
)
Taylor, Bryan
( Mayo Clinic
, Jacksonville
, Florida
, United States
)
Farres, Sam
( Mayo Clinic
, Jacksonville
, Florida
, United States
)
Landolfo, Kevin
( Mayo Clinic
, Jacksonville
, Florida
, United States
)
Author Disclosures:
Kiyan Heybati:DO NOT have relevant financial relationships
| Brian Shapiro:DO NOT have relevant financial relationships
| Domenic Ochal:No Answer
| Keshav Poudel:No Answer
| Eric Zuberi:No Answer
| Kevin Tayon:No Answer
| Elizabeth Dineen:DO NOT have relevant financial relationships
| Bryan Taylor:DO NOT have relevant financial relationships
| Sam Farres:DO NOT have relevant financial relationships
| Kevin Landolfo:No Answer