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Cardiac rehabilitation and mid-term follow-up after transcatheter aortic valve implantation

Journal of Geriatric Cardiology 2014年第4期11卷 279-285页

作者： Renzo Zanettini Gemma Gatto ileana mori Maria Beatrice Pozzoni Stefano Pelenghi Luigi Martinelli Silvio Klugmann Cardiac Rehabilitation Centre Istituti Clinici di Perfezionamento Hospital via Bignami 1 20126 Milan Italy De Gasperis Cardiology and Cardiac Surgery Department Niguarda Ca' Granda Hospital Piazza Ospedale Maggiore 3 20162 Milan Italy

Background Evaluation of patient outcomes following transcatheter aortic valve implantation （TAVI） has usually been based on survival and clinical improvement. Studies on quality of life are limited, and data from comprehensive assessments after the procedure are lacking. Methods Sixty patients referred for cardiac rehabilitation after TAVI underwent in-hospital and after-discharge multidimensional assessments to evaluate clinical, functional, and nutritional statuses, degree of autonomy, cognitive impairment, depression and quality of life. Results On admission to rehabilitation, approximately half of the patients had severe functional impairment and dependence for basic activities of daily living. During their hospital stay, one-third of the patients suffered significant clinical complications and two had to be transferred to the implantation center. Despite this, the overall outcome was very good. All of the remaining patients were clinically stable at discharge and functional status, autonomy and quality of life were improved in most. During a mean follow-up of 540 days （range： 192-738 days）, five patients died from noncardiac causes, three were hospitalized for cardiac events, and nine for non cardiac reasons. Functional status and autonomy remained satisfactory in the majority of patients and most continued to live independently. Conclusions Patients referred for rehabilitation after TAVI are often very frail, with a high grade of functional impairment, dependence on others and high risk of clinical complications. During a rehabilitation programme, based on a multidimensional assessment and intervention, most patients showed significant improvement in functional status, quality of life, and autonomy, which remained stable in the majority of subjects during mid-term follow-up.

关键词： Cardiac rehabilitation Comprehensive assessment Follow-up Transcatheter aortic valve implantation

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