French registry of cases of type I acute aortic dissection admitted to a cardiac rehabilitation center after surgery

Abstract

Background: After surgery for type I acute aortic dissection, the aorta remains partly dissected. This new population of patients is now referred to cardiac rehabilitation centers (CRCs). The feasibility of subsequent physical exercise is unknown.

Methods: Thirty-three consecutive patients (aged 55.1+/-9.3 years) were included in a prospective registry with clinical and radiological follow-up for 1 year after admission to a CRC. Twenty-six patients had undergone standard training sessions with exercise on a bicycle ergometer. Physical training programs included calisthenics, respiratory physiotherapy, walking, and cycling. Seven patients did not perform standard exercise training sessions but only walking and respiratory physiotherapy.

Results: For trained patients, the sessions (18+/-10) were carried out at 11.3+/-1.5 on the Borg scale ('light'), with blood pressure monitoring on exercise (<160 mmHg in 75% of patients). Maximum workload during exercise test (bicycle ergometer, 10 watts/min) increased from 62.7+/-11.8 to 91.6+/-16.5 watts (P=0.002). We identified three complications in two patients requiring further thoracic aorta surgery during follow-up. There was also one case of aortic valve replacement after 5 months and three cases of peripheral ischemia. No deaths, cerebral vascular accidents, or myocardial infarctions were recorded. Ten of the 19 patients of working age were able to return to work.

Conclusion: Physical training of moderate intensity seems feasible and beneficial in postsurgical type I aortic dissection patients.