Internal Medicine Resident University of British Columbia Vancouver, British Columbia, Canada
Background: Cardiac rehabilitation following surgery for aortic aneurysm or dissection is a class 1 guideline-based recommendation (AHA/ACC). However, limited data exist on patient participation and outcomes. The primary objective was to describe baseline characteristics, attendance, and completion rates for patients participating in cardiac rehabilitation for primary aortic indications in a large tertiary cardiac rehabilitation program. Secondary objectives included change in estimated cardiorespiratory fitness and blood pressure as well as assessment of safety outcomes.
METHODS AND RESULTS: Retrospective observational cohort study of patients participating in the Vancouver General Hospital program for a primary aortic indication, including post-aneurysm or dissection repair, and medically managed dissection from March 2021 to January 2025. Patients who were enrolled in and either completed or dropped out were included. T-tests (paired and unpaired) were used for continuous variables. Fisher’s exact test was used for categorical variables. A p-value < 0.05 was considered significant. Forty-four patients (mean age 60+/-16 years; 75% male) met inclusion criteria, including 29 (66%) post-aneurysm repair and 15 (34%) post-dissection (Table 1). Of the 15 post-dissection patients, 12 were Type A dissections and underwent surgical repair. Three were Type B dissections, 2 repaired and 1 medically managed. Ten patients had a residual dissection post-repair. The most common etiology of aortic disease was hypertensive-related (n=22; 50%), followed by bicuspid aortic valve associated aortopathy (n=9; 20%). Twenty-nine (66%) underwent concomitant aortic valve surgery. Patients attended an average of 20+/-13 exercise classes across virtual and in-person formats. The completion rate was 73% (n=32) with the average time in the program of 31+/-19 weeks. Average estimated metabolic equivalents of task (METs) on intake stress testing (n=40; 91%) was 8.8+/-3.8. In participants who completed an exit stress test (n=22; 50%), there was an increase of 1.6 METs (8.4 vs 10.0; CI: 0.6, 2.5; p=0.002) (Figure 1). There was no significant change in resting or peak systolic blood pressure across the program. No significant adverse events were observed during the study period.
Conclusion: Cardiac rehabilitation for primary aortic indications is associated with high participation and completion rates, with improvements in estimated cardiorespiratory fitness, but no significant change in resting or peak blood pressure. These findings highlight the potential benefits of structured cardiac rehabilitation participation in this population while reinforcing the need for further research on optimizing outcomes.
