Abstract 17793: Importance of Preoperative Pulmonary Rehabilitation in Patients With Thoracic Aortic Diseases
Background: Preoperative pulmonary rehabilitation (PR), in addition to post-operative PR, is known to have beneficial effects in general. However, it remains to be examined whether preoperative PR is also safe and effective for patients with thoracic aortic disease.
Hypothesis: We assessed the hypothesis that the incidences of pulmonary complications were reduced in the PR group compared with the control group.
Methods: We examined 128 consecutive patients who underwent elective surgery for thoracic aortic disease (aortic aneurysm in 88 and aortic dissection in 40) and post-operative PR in our hospital since January 1, 2010. Among them, pre-operative PR [20 min/day, mean 12 days, active cycle breathing technique (ACBT) contains a cycle of including breathing control, thoracic expansion, and forced expansion technique] was performed in 77 patients (PR group) on the basis of ACBTs with careful monitoring of blood pressure. All patients received standard cardiovascular rehabilitation after the surgery.
Results: Although the PR group, as compared with the control group without pre-operative PR (n=51), was characterized by higher prevalence of hypertension, reduced physical activity and concomitant valve surgery (all P<0.05), other clinical characteristics [e.g. age, sex and chronic obstructive pulmonary disease (COPD)] were comparable between the 2 groups. The preoperative PR caused no adverse events. Importantly, the incidences of pulmonary complications and median length of ICU stay were significantly reduced in the PR group compared with the control group (54.9 vs. 39.0% and 11.5 vs. 7.9 days, respectively, both P<0.05). Furthermore, the incidences of re-intubation and support with non-invasive positive pressure ventilation were significantly reduced in the PR group compared with the control group (11.8 vs. 1.3% and 21.6 vs. 6.5%, respectively, both P<0.05). Importantly, the incidence of pulmonary complications in patients with aortic disease and COPD was significantly reduced in the PR group compared with the control group (P<0.05).
Conclusions: These results indicate that preoperative PR is safe and effective for patients with thoracic aortic disease, demonstrating the usefulness of PR in the pre-operative management of those patients.
Author Disclosures: M. Takeuchi: None. Y. Matsumoto: None. S. Kawamoto: None. K. Kumagai: None. H. Amamizu: None. K. Ohyama: None. H. Uzuka: None. K. Nishimiya: None. M. Kohzuki: None. Y. Saiki: None. H. Shimokawa: None.
- © 2016 by American Heart Association, Inc.