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A Comparative Analysis of Open Heart Surgery and Minimally Invasive Cardiac Surgery in Exercise-Based Cardiac Rehabilitation

Hubisz, Maciej Marek; van der Stouwe, Jan Gerrit; Ziob, Mira; Steiner, Sonja; Uzun, Neslihan; Weibel, Sandra; Lesan, Vlada; Erni, Dominic; Meier-Ruge, Ladina; Rodriguez Cetina Biefer, Hector; Dzemali, Omer; Vontobel, Jan; Niederseer, David (2024). A Comparative Analysis of Open Heart Surgery and Minimally Invasive Cardiac Surgery in Exercise-Based Cardiac Rehabilitation. Journal of Cardiothoracic Surgery, 19(1):390.

Abstract

BACKGROUND
Historically, the majority of patients admitted to inpatient exercise-based cardiac rehabilitation (EBCR) have undergone open heart surgery (OHS). However, with advances in minimally invasive cardiac surgery (MICS), these patient groups are also increasingly referred for inpatient EBCR. Herein, we aimed to compare the progress of these groups during rehabilitation.

METHODS
In this prospective, nonrandomized study, 403 inpatient EBCR patients were recruited from December 2022 until September 2023 and stratified into two groups: OHS, and MICS. Participants completed a 3-4-week certified EBCR program. The primary endpoint was defined as a change in the 6-minute walk test (6MWT). Moreover, a comprehensive panel of quality-of-life (QoL) assessments were performed at admission and discharge.

RESULTS
At baseline, patients with OHS were older (66 years [IQR 59 - 72]), more often male (83%), and underwent emergency/urgent procedures more often (20%) than patients with MICS. Furthermore, patients with MICS showed a better 6MWT at admission (426 meters [IQR 336 - 483]) compared to patients with OHS (381 meters [IQR 299 - 453]). While all patients were able to increase the distance in the 6MWT, regression analyses in fully adjusted models showed no difference in improvements between the two groups (β -5, 95% CI, -26 - 14, p = 0.58). Moreover, during EBCR, we observed significant improvements in all QoL measures in all groups.

CONCLUSIONS
In this study, improvements in fitness, as assessed by the 6WMT were observed in all groups. Furthermore, multiple QoL measures improved equally across all groups. These encouraging results emphasize the importance of EBCR.

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiac Surgery
04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiology
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Surgery
Health Sciences > Pulmonary and Respiratory Medicine
Health Sciences > Cardiology and Cardiovascular Medicine
Language:English
Date:27 June 2024
Deposited On:08 Jan 2025 07:32
Last Modified:30 Apr 2025 01:37
Publisher:BioMed Central
ISSN:1749-8090
OA Status:Gold
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1186/s13019-024-02871-z
PubMed ID:38926740
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