Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2021 May 7;5(5):CD010876.
doi: 10.1002/14651858.CD010876.pub3.

Exercise-based cardiac rehabilitation for adults after heart valve surgery

Lizette N Abraham  1 , Kirstine L Sibilitz  2 , Selina K Berg  2 , Lars H Tang  3   4 , Signe S Risom  5   6   7 , Jane Lindschou  8 , Rod S Taylor  9 , Britt Borregaard  10 , Ann-Dorthe Zwisler  11   12
Affiliations
Meta-Analysis

Exercise-based cardiac rehabilitation for adults after heart valve surgery

Lizette N Abraham et al. Cochrane Database Syst Rev. .

Abstract

Background: The impact of exercise-based cardiac rehabilitation (CR) following heart valve surgery is uncertain. We conducted an update of this systematic review and a meta-analysis to assess randomised controlled trial evidence for the use of exercise-based CR following heart valve surgery.

Objectives: To assess the benefits and harms of exercise-based CR compared with no exercise training in adults following heart valve surgery or repair, including both percutaneous and surgical procedures. We considered CR programmes consisting of exercise training with or without another intervention (such as an intervention with a psycho-educational component).

Search methods: We searched the Cochrane Central Register of Clinical Trials (CENTRAL), in the Cochrane Library; MEDLINE (Ovid); Embase (Ovid); the Cumulative Index to Nursing and Allied Health Literature (CINAHL; EBSCO); PsycINFO (Ovid); Latin American Caribbean Health Sciences Literature (LILACS; Bireme); and Conference Proceedings Citation Index-Science (CPCI-S) on the Web of Science (Clarivate Analytics) on 10 January 2020. We searched for ongoing trials from ClinicalTrials.gov, Clinical-trials.com, and the World Health Organization International Clinical Trials Registry Platform on 15 May 2020.

Selection criteria: We included randomised controlled trials that compared exercise-based CR interventions with no exercise training. Trial participants comprised adults aged 18 years or older who had undergone heart valve surgery for heart valve disease (from any cause) and had received heart valve replacement or heart valve repair. Both percutaneous and surgical procedures were included.

Data collection and analysis: Two review authors independently extracted data. We assessed the risk of systematic errors ('bias') by evaluating risk domains using the 'Risk of bias' (RoB2) tool. We assessed clinical and statistical heterogeneity. We performed meta-analyses using both fixed-effect and random-effects models. We used the GRADE approach to assess the quality of evidence for primary outcomes (all-cause mortality, all-cause hospitalisation, and health-related quality of life).

Main results: We included six trials with a total of 364 participants who have had open or percutaneous heart valve surgery. For this updated review, we identified four additional trials (216 participants). One trial had an overall low risk of bias, and we classified the remaining five trials as having some concerns. Follow-up ranged across included trials from 3 to 24 months. Based on data at longest follow-up, a total of nine participants died: 4 CR versus 5 control (relative risk (RR) 0.83, 95% confidence interval (CI) 0.26 to 2.68; 2 trials, 131 participants; GRADE quality of evidence very low). No trials reported on cardiovascular mortality. One trial reported one cardiac-related hospitalisation in the CR group and none in the control group (RR 2.72, 95% CI 0.11 to 65.56; 1 trial, 122 participants; GRADE quality of evidence very low). We are uncertain about health-related quality of life at completion of the intervention in CR compared to control (Short Form (SF)-12/36 mental component: mean difference (MD) 1.28, 95% CI -1.60 to 4.16; 2 trials, 150 participants; GRADE quality of evidence very low; and SF-12/36 physical component: MD 2.99, 95% CI -5.24 to 11.21; 2 trials, 150 participants; GRADE quality of evidence very low), or at longest follow-up (SF-12/36 mental component: MD -1.45, 95% CI -4.70 to 1.80; 2 trials, 139 participants; GRADE quality of evidence very low; and SF-12/36 physical component: MD -0.87, 95% CI -3.57 to 1.83; 2 trials, 139 participants; GRADE quality of evidence very low). AUTHORS' CONCLUSIONS: Due to lack of evidence and the very low quality of available evidence, this updated review is uncertain about the impact of exercise-CR in this population in terms of mortality, hospitalisation, and health-related quality of life. High-quality (low risk of bias) evidence on the impact of CR is needed to inform clinical guidelines and routine practice.

Trial registration: ClinicalTrials.gov NCT03270124 NCT03966417 NCT04166682 NCT03709511 NCT03801460 NCT02805309 NCT03470246 NCT00860678.

PubMed Disclaimer

Conflict of interest statement

Lizette Abraham declares no conflict of interest.

Kirstine L Sibilitz, Selina K Berg, Lars H Tang, Signe S Risom, Britt Borregaard, Jane Lindschou, Rod Taylor, and Ann‐Dorthe Zwisler are involved in conducting previous and/or current randomised clinical trials (including the included trial of Sibilitz et al) investigating the effects of cardiac rehabilitation for different cardiac populations. None of these trials were or are industry sponsored, but studies were sponsored by private and public funding. None of the founders had any involvement in analyses, collection of data, or interpretation of trial results.

Kirstine L Sibilitz and Ann‐Dorthe Zwisler are currently co‐authoring other Cochrane Reviews of cardiac rehabilitation.

Rod S Taylor is an author on previous Cochrane Reviews on cardiac rehabilitation and is the Chief Investigator for ongoing trials (REACH‐HFpEF, SCOT:REACH‐HF, DK:REACH‐HF) assessing the clinical effectiveness and cost‐effectiveness of home‐based self‐directed exercise‐based cardiac rehabilitation interventions for patients with heart failure and their carers.

Ann‐Dorthe Zwisler declares financial support for expert testimony as part of her employment as professor.

Figures

1
1
Updated study flow diagram.
1.1
1.1. Analysis
Comparison 1: Exercise versus no exercise, Outcome 1: All‐cause mortality at longest follow‐up
1.2
1.2. Analysis
Comparison 1: Exercise versus no exercise, Outcome 2: All‐cause mortality: best/worst‐case scenario
1.3
1.3. Analysis
Comparison 1: Exercise versus no exercise, Outcome 3: All‐cause mortality: worst/best‐case scenario
1.4
1.4. Analysis
Comparison 1: Exercise versus no exercise, Outcome 4: All‐cause hospitalisation at longest follow‐up
1.5
1.5. Analysis
Comparison 1: Exercise versus no exercise, Outcome 5: HRQoL (mental component) at end of intervention
1.6
1.6. Analysis
Comparison 1: Exercise versus no exercise, Outcome 6: HRQoL (physical component) at end of intervention
1.7
1.7. Analysis
Comparison 1: Exercise versus no exercise, Outcome 7: HRQoL (mental component) at maximum follow‐up
1.8
1.8. Analysis
Comparison 1: Exercise versus no exercise, Outcome 8: HRQoL (physical component) at maximum follow‐up
1.9
1.9. Analysis
Comparison 1: Exercise versus no exercise, Outcome 9: Exercise capacity (direct: VO2 max) at end of intervention
1.10
1.10. Analysis
Comparison 1: Exercise versus no exercise, Outcome 10: Exercise capacity (direct: VO2 max) at longest follow‐up
1.11
1.11. Analysis
Comparison 1: Exercise versus no exercise, Outcome 11: Exercise capacity (maximum measures) at end of Intervention
1.12
1.12. Analysis
Comparison 1: Exercise versus no exercise, Outcome 12: Exercise capacity (maximum measures) at longest follow‐up
1.13
1.13. Analysis
Comparison 1: Exercise versus no exercise, Outcome 13: Exercise capacity (indirect/submaximal: 6MWT) at end of Intervention
1.14
1.14. Analysis
Comparison 1: Exercise versus no exercise, Outcome 14: Exercise capacity (indirect/submaximal: 6MWT) at longest follow‐up
1.15
1.15. Analysis
Comparison 1: Exercise versus no exercise, Outcome 15: Serious adverse events
1.16
1.16. Analysis
Comparison 1: Exercise versus no exercise, Outcome 16: Return to work
See this image and copyright information in PMC

Update of

References

References to studies included in this review

Lin 2004 {published data only}
    1. Lin CY, He Z, Chen J, Yang B, Gu JX. Efficacy analysis of rehabilitation therapy on patients with heart valve replacement. Chinese Journal of Clinical Rehabilitation 2004;8:426-7.
Nilsson 2019 {published data only}
    1. Nilsson H, Nylander E, Borg S, Tamas E, Hedman K. Cardiopulmonary exercise testing for evaluation of a randomized exercise training intervention following aortic valve replacement. Clinical Physiology and Functional Imaging 2019;39(1):103–10. - PMC - PubMed
Pressler 2016 {published data only}
    1. NCT01935297. Exercise training after transcatheter aortic valve implantation (SPORT:TAVI). clinicaltrials.gov/ct2/show/NCT01935297 (first posted 5 September 2013).
    1. Pressler A, Forschner L, Hummel J, Haller B, Christle JW, Halle M. Long-term effect of exercise training in patients after transcatheter aortic valve implantation: follow-up of the SPORT:TAVI randomised pilot study. European Journal of Preventative Cardiology 2018;25(8):794-801. - PubMed
    1. Pressler A, Christle JW, Lechner B, Grabs V, Haller B, Hettich I, et al. Exercise training improves exercise capacity and quality of life after transcatheter aortic valve implantation: a randomized pilot trial. American Heart Journal 2016;182:44-53. - PubMed
Rogers 2018 {published data only}
    1. Rogers P, Al-Aidrous S, Banya W, Haley SR, Mittal T, Kabir T, et al. Cardiac rehabilitation to improve health-related quality of life following trans-catheter aortic valve implantation: a randomised controlled feasibility study RECOVER–TAVI Pilot, ORCA 4, for the Optimal Restoration of Cardiac Activity Group. Pilot and Feasibility Studies 2018;13(4):185. - PMC - PubMed
Sibilitz 2016 {published data only}
    1. Hansen TB, Zwisler AD, Berg SK, Sibilitz KL, Thygesen LC, Kjellberg J, et al. Cost-utility analysis of cardiac rehabilitation after conventional heart valve surgery versus usual care. European Journal of Preventive Cardiology 2017;24:698-707. [DOI: 10.1177/2047487317689908] - DOI - PubMed
    1. NCT01558765. CopenHeartVR - integrated rehabilitation of patients after heart valve surgery (CopenHeartVR). clinicaltrials.gov/ct2/show/NCT01558765 (first posted 20 March 2012).
    1. Sibilitz KL, Berg SK, Rasmussen TB, Risom SS, Thygesen LC, Tang L, et al. Cardiac rehabilitation increases physical capacity but not mental health after heart valve surgery: a randomised clinical trial. Heart 2016;102:1995–2003. - PubMed
Sire 1987 {published data only}
    1. Sire S. Physical training and occupational rehabilitation after aortic valve replacement. European Heart Journal 1987;8:1215-20. - PubMed

References to studies excluded from this review

Amat Santos 2012 {unpublished data only}
    1. Amat Santos IJ, Duro IC, Hernandez Luis C, Alvarado M, De La Fuente L, Amado MG, et al. Benefits of cardiac rehabilitation programmes in high-risk patients with symptomatic chronic heart failure and low left ventricular ejection fraction. In: European Heart Journal. Vol. 33. 2012:1056.
Bakhshayesh 2018 {published data only}
    1. IRCT20180730040643N1. The effect of IT interventions in cardiac rehabilitation patients [Home based cardiac rehabilitation after coronary angioplasty and heart surgery using booklet and mobile application: assessing the impact of interventions on health related quality of life]. en.irct.ir/trial/33791 (first received 3 November 2018).
Batra 2012 {published and unpublished data}
    1. Batra AS, McElhinney DB, Wang W, Zakheim R, Garofano RP, Daniels C, et al. Cardiopulmonary exercise function among patients undergoing transcatheter pulmonary valve implantation in the US Melody valve investigational trial. American Heart Journal 2012;163:280-7. - PubMed
Brosseau 1995 {published and unpublished data}
    1. Brosseau R, Juneau M, Sirard A, Savard A, Marchand C, Boudreau MH, et al. Safety and feasibility of a self monitored, home-based phase II exercise program for high risk patients after cardiac surgery [La securite d'un entrainement a domicile en phase II apres une chirurgie cardiaque pour les patients a haut risque]. Canadian Journal of Cardiology 1995;11:675-85. - PubMed
Cargnin 2019 {published data only}
    1. Cargnin C, Karsten M, Guaragna JCVDC, Dal Lago P. Inspiratory muscle training after heart valve replacement surgery improves inspiratory muscle strength, lung function, and functional capacity: a randomized controlled trial. Journal of Cardiopulmonary Rehabilitation and Prevention 2019;39(5):E1-E7. - PubMed
Chambers 2005 {published and unpublished data}
    1. Chambers J, Rimington H, Rajani R, Hodson F, Blauth C. Reply [2]. Journal of Heart Valve Disease 2005. - PubMed
Chan 2012 {published and unpublished data}
    1. Chan CL, Wang CW, Ho RT, Ho AH, Ziea ET, Taam Wong VC, et al. A systematic review of the effectiveness of qigong exercise in cardiac rehabilitation. American Journal of Chinese Medicine 2012;40:255-67. - PubMed
CTRI 2017 {published data only}
    1. CTRI/2017/09/009707. Effect of physiotherapy in open heart surgery patients [Maximum inspiratory pressure, functional status and quality of life of the patients after open heart surgery following physiotherapy]. www.who.int/trialsearch/Trial2.aspx?TrialID=CTRI/2017/09/009707 (first received 2017).
de Charmoy 2000 {published and unpublished data}
    1. Charmoy SB, Eales CJ. The role of prophylactic chest physiotherapy after cardiac valvular surgery: is there one? South African Journal of Physiotherapy 2000;56:24-8.
Deepa 2018 {published data only}
    1. CTRI/2018/02/011705. To compare the utility and efficacy of the routine exercise program and bicycle ergometer program among heart valve surgery patients [Role of bicycle ergometer training in phase one among heart valve surgery patients]. www.who.int/trialsearch/Trial2.aspx?TrialID=CTRI/2018/02/011705 (first received 2018).
Dull 1983 {published and unpublished data}
    1. Dull JL, William JL. Are maximal inspiratory breathing exercises or incentive spirometry better than early mobilization after cardiopulmonary bypass? Physical Therapy 1983;63:655-9. - PubMed
Editorial 2018 {published data only}
    1. Francesco G, Carlo V. Editorial to 'Comparison of phase 2 cardiac rehabilitation outcomes between patients after transcatheter versus surgical aortic valve replacement'. European Journal of Preventive Cardiology 2018;25(15):1575‐6. - PubMed
Fang 2002 {published and unpublished data}
    1. Fang W, Chen YT, Liang JJ. Effects of early rehabilitative guidance on quality of life after cardiac valve replacement. Chinese Journal of Clinical Rehabilitation 2002;6:1106-7.
Ferreira 2009 {published and unpublished data}
    1. Ferreira PE, Rodrigues AJ, Evora PR. Effects of an inspiratory muscle rehabilitation program in the postoperative period of cardiac surgery. Arquivos Brasileiros de Cardiologia 2009;92:275-82. - PubMed
Fontes Cerqueira 2018 {published data only}
    1. Fontes Cerqueira TC, De Cerqueira Neto ML, De Assis Pereira Cacau L, Oliveira GU, Da Silva WM, Carvalho VO, et al. Ambulation capacity and functional outcome in patients undergoing neuromuscular electrical stimulation after cardiac valve surgery: a randomised clinical trial. Medicine (United States) 2018;97(46):e13012. - PMC - PubMed
Gaita 1999 {published and unpublished data}
    1. Gaita D, Branea I, Dragulescu S, Gaita A, Socoteanu I, Gaspar M, et al. Benefit of Exercise Training in Patients With Valve Prostheses and Chronic Heart Failure. Bologna: Medimond S R L, 1999.
Ghalamghash 2008 {published and unpublished data}
    1. Ghalamghash R, Goosheh B, Emrani A, Keyhani MR. Effect of cardiac rehabilitation program on functional capacity following valvular heart surgery. Journal of Medical Council of Islamic Republic of Iran 2008;26:292-3.
Gortner 1988 {published and unpublished data}
    1. Gortner SR, Gilliss CL, Shinn JA, Sparacino PA, Rankin S, Leavitt M, et al. Improving recovery following cardiac surgery: a randomized clinical trial. Journal of Advanced Nursing 1988;13:649-61. - PubMed
Green 2013 {published and unpublished data}
    1. Green P, Kirtane A, Genereux P, McAndrew T, Hueter I, Alu M, et al. The impact of six-minute walk test performance on outcomes after transcatheter aortic valve replacement: insights from the PARTNER trial. Journal of the American College of Cardiology 2013;62:E1971. - PMC - PubMed
Grunewald 1971 {published and unpublished data}
    1. Grunewald B. Prevention and rehabilitation of rheumatic heart valve diseases. Zeitschrift fur Allgemeinmedizin 1971;47:705-9. - PubMed
Ha 2011 {published and unpublished data}
    1. Ha YK, Jung YY. Development and application of an early exercise program for open heart surgery patients. Journal of Korean Critical Care Nursing 2011;4:1.
Hokanson 2011 {published and unpublished data}
    1. Hokanson JS, Ralphe JC. Exercise restrictions after balloon aortic valvuloplasty (Letter to the Editor). Journal of the American College of Cardiology (JACC) 2011;57:2034. - PubMed
Hui 2006 {published and unpublished data}
    1. Hui PN, Wan M, Chan WK, Yung PM. An evaluation of two behavioral rehabilitation programs, qigong versus progressive relaxation, in improving the quality of life in cardiac patients. Journal of Alternative & Complementary Medicine 2006;12:373-8. - PubMed
Jairath 1995 {published and unpublished data}
    1. Jairath N, Salerno T, Chapman J, Dornan J, Weisel R. The effect of moderate exercise training on oxygen uptake post-aortic/mitral valve surgery. Journal of Cardiopulmonary Rehabilitation 1995;15:424-30. - PubMed
Johnson 1996 {published and unpublished data}
    1. Johnson D, Kelm C, Thomson D, Burbridge B, Mayers I. The effect of physical therapy on respiratory complications following cardiac valve surgery. Chest 1996;109:638-44. - PubMed
Kardis 2007 {published and unpublished data}
    1. Kardis P, Sherman M, Barnett SD. Association of age and quality of life following phase II cardiac rehabilitation. Journal of Nursing Care Quality 2007;22:255-9. - PubMed
Kassirskii 1983 {published and unpublished data}
    1. Kassirskii GI, Semenovskii ML, Petrunina LV, Fomina NG. Evaluation of patient rehabilitation effectiveness after aortic valve prosthesis based on spiroergometric study data. Kardiologiia 1983;23:82-6. - PubMed
Kassirskii 1991 {published and unpublished data}
    1. Kassirskii GI, Grosheva TV. Physical rehabilitation using bicycle ergometry training of patients after aortic valve replacement. Terapevticheskii Arkhiv 1991;63:59-62. - PubMed
Kodric 2013 {published and unpublished data}
    1. Kodric M, Trevisan R, Torregiani C, Cifaldi R, Longo C, Cantarutti F, et al. Inspiratory muscle training for diaphragm dysfunction after cardiac surgery. Journal of Thoracic & Cardiovascular Surgery 2013;145:819-23. - PubMed
Kübler 1984 {published data only (unpublished sought but not used)}
    1. Kübler W, Opherk D. Angina pectoris with normal coronary arteries. Acta Medica Scandinavica. Supplementum 1984;694:55-7. - PubMed
Liao 2004 {published and unpublished data}
    1. Liao B, Liu H, Chen L, Guo SM, Liu AM, et al. Effect of psychological and behavioral interventions on the negative emotion of patients with heart valve replacements during perioperative period. Chinese Journal of Clinical Rehabilitation 2004;8:7360-1.
Lim 1998 {published and unpublished data}
    1. Lim HY, Lee CW, Park SW, Kim JJ, Song JK, Hong MK, et al. Effects of percutaneous balloon mitral valvuloplasty and exercise training on the kinetics of recovery oxygen consumption after exercise in patients with mitral stenosis. European Heart Journal 1998;19:1865-71. - PubMed
Martsinkiavichus 1980 {published and unpublished data}
    1. Martsinkiavichus A, Paliushchinskaia N, Iozaitis M, Zhukauskene I, Norvilene A, et al. Physical activity and the work capacity of patients with artificial heart valves before and after rehabilitation. Kardiologiia 1980;20:28-31. - PubMed
McDermott 2019 {published data only}
    1. McDermott C, McCormack CM, McDermott L, O'Shea O, Kelly SM, McCarren A, et al. Comparison of selected health indices in Irish and Belgian participants commencing a home-based, technology enabled cardiac rehabilitation program. European Journal of Preventive Cardiology 2019;26:S40-S41.
Nagashio 2003 {published and unpublished data}
    1. Nagashio M, Suzuki Y, Onishi Y, Tomatsu A, Shimada Y, Okamura S, et al. Post-operative cardiac rehabilitation programs for early returning to daily life activities: self-measurement of heart rate and blood pressure during staying at home trial. Journal of Cardiology 2003;41:91-5. - PubMed
Nehyba 2009 {published data only}
    1. Nehyba S, Chaloupka V, Soucek R, Chaloupkova S, Vysoky R, Stetka F, et al. The programme of managed ambulatory rehabilitation for patients after heart valve defect surgery. Vnitrni Lekarstvi 2009;55:1118-25. - PubMed
Newell 1980 {published and unpublished data}
    1. Newell JP, Kappagoda CT, Stoker JB, Deverall PB, Watson DA, Linden RJ. Physical training after heart valve replacement. British Heart Journal 1980;44:638-49. - PMC - PubMed
Patel 2019 {published data only}
    1. Patel D, Duncan M, Shah A, Lindman B, Greevy R, Savage P, et al. Association of cardiac rehabilitation with decreased hospitalization and mortality risk after cardiac valve surgery. JAMA Cardiology 2019;4(12):1250-9. - PMC - PubMed
Peng 2018 {published data only}
    1. Peng X, Su Y, Hu Z, Sun X, Li X, Dolansky MA, et al. Home-based telehealth exercise training program in Chinese patients with heart failure: a randomized controlled trial. Medicine (United States) 2018;97(35):e12069. - PMC - PubMed
Petrunina 1980 {published and unpublished data}
    1. Petrunina LV. Patient physical rehabilitation after mitral or aortic valve prosthesis. Kardiologiia 1980;20:50-3. - PubMed
Prasciene 2019 {published data only}
    1. Prasciene E, Icking N, Kisieliute E, Kubilius R, Bjarnason-Wehrens B, et al. Feasibility and short-term effectiveness of an additional resistance and balance training in cardiac rehabilitation for older patients after valve surgery: results of a pilot study. European Journal of Preventive Cardiology 2019;26:S39.
Pressler 2015 {published data only}
    1. Pressler A, Lechner B, Christle J, Bleiziffer S, Mehilli J, Jochheim D, et al. Safety, applicability and outcome of regular exercise training after transcatheter aortic valve implantation: a randomized pilot trial. European Journal of Preventive Cardiology 2015;22 Suppl 1:S78.
RBR‐8swgc3 2017 {published data only}
    1. RBR‐8swgc3. Inspiratory muscle training in patients after cardiac surgery [Inspiratory muscle training in patients undergoing cardiac surgery]. http://www.who.int/trialsearch/Trial2.aspx?TrialID=RBR-8swgc3 (first received 2019).
Rizwan 2012 {published and unpublished data}
    1. Rizwan A, Jalwan J, Mukherjee S. To compare the immediate effect of deep breathing exercise and incentive spirometry on ABG after mitral valve replacement surgery. Indian Journal of Physiotherapy & Occupational Therapy 2012;6:12-7.
Rogers2018 {published data only}
    1. Rogers P, Banya W, Kabir T, Panoulas V, Probert H, Prendergast C, et al. Does cardiac rehabilitation improve functional, independence, frailty and emotional outcomes following trans catheter aortic valve replacement? European Heart Journal 2018;39 Suppl 1:1121.
Roseler 1997 {published and unpublished data}
    1. Roseler S, Schwartz FW, Karoff M. Evaluation of the effectiveness of an ambulatory after-care rehabilitation program. Gesundheitswesen 1997;59:236-41. - PubMed
Rosenfeldt 2011 {published and unpublished data}
    1. Rosenfeldt F, Braun L, Spitzer O, Bradley S, Shepherd J, Bailey M, et al. Physical conditioning and mental stress reduction - a randomised trial in patients undergoing cardiac surgery. BMC Complementary & Alternative Medicine 2011;11:20. - PMC - PubMed
Royse 2015 {published data only}
    1. ACTRN12615000968572. Sternal management accelerated recovery trial (S.M.A.R.T.): the efficacy of modified sternal precautions on improving physical function in patients following cardiac surgery via a midline sternal incision [A randomized controlled trial of the efficacy of modified sternal precautions versus standard care on improving physical function following cardiac surgery via a median sternotomy]. www.who.int/trialsearch/Trial2.aspx?TrialID=ACTRN12615000968572 (first received 2019).
Song 2019 {published data only}
    1. Song F, Zhan H, Liang Y, He X, Guo L, et al. Cardiac rehabilitation improved oxygen uptake measured by cardiopulmonary exercise test in patients after aortic valve surgery. Reviews in Cardiovascular Medicine 2019;20(1):47-52. - PubMed
Stoickov 2018 {published data only}
    1. Stoickov V, Deljanin Ilic M, Stoickov M, Marinkovic D, Simonovic D, Golubovic M, et al. Impact of short-term exercise training on QT dispersion and double product in patients after surgical aortic valve replacement. European Heart Journal 2018;39:85-6.
Sumide 2009 {published and unpublished data}
    1. Sumide T, Shimada K, Ohmura H, Onishi T, Kawakami K, Masaki Y, et al. Relationship between exercise tolerance and muscle strength following cardiac rehabilitation: comparison of patients after cardiac surgery and patients with myocardial infarction. Journal of Cardiology 2009;54:273-81. - PubMed
Tang 2019 {published data only}
    1. Tang LH, Zwisler AD, Doherty P, Oldridge N, Berg SK, Christensen J. Changes in physical performance and their association with health-related quality of life in a mixed nonischemic cardiac population that participates in rehabilitation. Journal of Cardiopulmonary Rehabilitation and Prevention 2020;40(2):102-7. - PubMed
Therrien 2003 {published and unpublished data}
    1. Therrien J, Fredriksen PM, Walker M, Granton J, Reid GJ, Webb G. A pilot study of exercise training in adult patients with repaired tetralogy of Fallot. Canadian Journal of Cardiology 2003;19:685-9. - PubMed
Ueshima 2004 {published data only (unpublished sought but not used)}
    1. Ueshima K, Kamata J, Kobayashi N, Saito M, Sato S, Kawazoe K, et al. Effects of exercise training after open heart surgery on quality of life and exercise tolerance in patients with mitral regurgitation or aortic regurgitation. Japanese Heart Journal 2004;45(5):789-97. - PubMed
Viana 2018 {published data only}
    1. RBR‐8ysb3n. Evaluation of the physiotherapy with cycle ergometer in the funcional recovery after cardiac surgery [Cycle ergometer and conventional physiotherapy in patients submitted the cardiac surgery]. www.who.int/trialsearch/Trial2.aspx?TrialID=RBR-8ysb3n (first received 2019).
Weber 2019 {published data only}
    1. DRKS00017239. Use of pre- and intensified post-procedural physiotherapy in patients with symptomatic aortic stenosis undergoing transcatheter aortic valve replacement - the 4P TAVR study. www.who.int/trialsearch/Trial2.aspx?TrialID=DRKS00017239 (first received 2019). - PMC - PubMed
Widimsky 2009 {published and unpublished data}
    1. Widimsky P, Suryapranata H. "PRAGUE" randomized clinical trials: pride of Czech cardiology. Cor et Vasa 2009;51(10):679-83.
Yan 2016 {published data only}
    1. Yan XY. Early rehabilitation mode in transcatheter domestic aortic valve implantation of perioperative implementation and effects on patient life ability. Journal of the Hong Kong College of Cardiology 2016;24:A25.
Yau 2018 {published data only}
    1. ChiCTR1800016098. PREQUEL (PREhabilitation for improving QUality of recovery after ELective cardiac surgery) study: a randomised controlled trial. www.who.int/trialsearch/Trial2.aspx?TrialID=ChiCTR1800016098 (first received 2019). - PMC - PubMed

References to ongoing studies

ACTIVE AFTER TAVR 2017 {published data only}
    1. NCT03270124. A pragmatiC sTrategy to Promote actIVity and Enhance Quality of Life AFTER Transcatheter Aortic Valve Replacement (ACTIVE AFTER TAVR): a pilot study. https://clinicaltrials.gov/ct2/show/NCT03270124 (first received 1 September 2017).
Exercise Training After TAVI {unpublished data only}
    1. NCT03966417. Exercise training after transcatheter aortic valve implantation (FitTAVI). clinicaltrials.gov/show/NCT03966417 (first received 29 May 2019).
Feng 2019 {published data only}
    1. ChiCTR‐IPR‐17011445. The effects of I stage cardiac rehabilitation on cardiopulmonary function in patients undergoing open heart surgery: a randomized controlled study. www.who.int/trialsearch/Trial2.aspx?TrialID=ChiCTR-IPR-17011445 (first received 2019).
HBCR‐TAVR 2019 {published data only}
    1. NCT04166682. Impact of home-based cardiac rehabilitation on outcomes after TAVR (HBCR-TAVR). https://clinicaltrials.gov/ct2/show/NCT04166682 (first received 18 November 2019).
Post Cardiac Valvular Surgery Rehabilitation (PORT {published data only}
    1. NCT03709511. Post cardiac valvular surgery rehabilitation (PORT). https://clinicaltrials.gov/ct2/show/NCT03709511 (first received 17 October 2018).
PREPARE TAVR Pilot Study {unpublished data only}
    1. NCT01504737. Rehabilitation in the form of exercise training in aortic stenosis patients (RASP). http://clinicaltrials.gov/show/NCT01504737 (first received 5 January 2012).
REHAB‐TAVR 2017 {published data only}
    1. NCT02805309. Home-based exercise program for recovery after transcatheter aortic valve replacement: a pilot study. https://clinicaltrials.gov/ct2/show/NCT02805309 (first received 20 June 2016).
The PACO Trial {published data only}
    1. Vasankari V, Jari Husu PY, Henri Tokola K, Jaana Sievanen H, Vesa Airaksinen J, Tommi Hartikainen J. Personalised eHealth intervention to increase physical activity and reduce sedentary behaviour in rehabilitation after cardiac operations: study protocol for the PACO randomised controlled trial. BMJ Open Sport & Exercise Medicine 2019;5(1):e000539. - PMC - PubMed
Valve‐ex 2009 {published data only}
    1. NCT00860678. Physical activity in patients after aortic valve replacement (Valve-ex). clinicaltrials.gov/ct2/show/NCT00860678 (first received 12 March 2009).
Wang 2019 {published data only}
    1. NCT04166682. Impact of home-based cardiac rehabilitation on outcomes after TAVR (HBCR-TAVR) [A study of the impact of home-based cardiac rehabilitation on outcomes after transcatheter aortic valve replacement (TAVR)]. clinicaltrials.gov/ct2/show/NCT04166682 (first received 18 November 2019).

Additional references

Ambrosetti 2020
    1. Ambrosetti M, Abreu A, Corra U, Davos CH, Hansen D, Frederix I, et al. Secondary prevention through comprehensive cardiovascular rehabilitation: from knowledge to implementation. 2020 update. A position paper from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology. European Journal of Preventive Cardiology 2020;0(0):1-42 [Epub ahead of print]. [DOI: 10.1177/2047487320913379] [PMID: PMID: 32223332] - DOI - PubMed
Anayo 2019
    1. Anayo L, Rogers P, Long L, Dalby M, Taylor R. Exercise-based cardiac rehabilitation for patients following open surgical aortic valve replacement and transcatheter aortic valve implant: a systematic review and meta-analysis. Open Heart 2019;6(1):e000922. [DOI: 10.1136/openhrt-2018-000922] [PMID: PMCID: PMC6519423 PMID: 31168371] - DOI - PMC - PubMed
Anderson 2014
    1. Anderson LJ, Taylor RS. Cardiac rehabilitation for people with heart disease: an overview of Cochrane systematic reviews. International Journal of Cardiology 2014;177(2):348-61. [DOI: ] - PubMed
Anderson 2016
    1. Anderson L, Thompson DR, Oldridge N, Zwisler AD, Rees K, Martin N, et al. Exercise‐based cardiac rehabilitation for coronary heart disease. Cochrane Database of Systematic Reviews 2016, Issue 1. Art. No: CD001800. [DOI: 10.1002/14651858.CD001800.pub3] - DOI - PMC - PubMed
BACPR 2012
    1. The British Association for Cardiovascular Prevention and Rehabilitation. The BACPR Standards and Core Components for Cardiovascular Disease Prevention and Rehabilitation 2012 (2nd edition). The British Cardiovascular Society 2012.
Balady 2007
    1. Balady GJ, Williams MA, Ades PA, Bittner V, Comoss P, Foody JM, et al. Core components of cardiac rehabilitation/secondary prevention programs: 2007 update. A scientific statement from the American Heart Association Exercise, Cardiac Rehabilitation, and Prevention Committee, the Council on Clinical Cardiology; the Councils on Cardiovascular Nursing, Epidemiology and Prevention, and Nutrition, Physical Activity, and Metabolism; and the American Association of Cardiovascular and Pulmonary Rehabilitation. Circulation 2007;115:2675-82. - PubMed
Baumgartner 2017
    1. Baumgartner H, Falk V, Bax JJ, De Bonis M, Hamm C, Holm PJ, et al. 2017 ESC/EACTS guidelines for the management of valvular heart disease. European Heart Journal 2017;38(36):2739-91. - PubMed
Ben‐Dor 2010
    1. Ben-Dor I, Pichard AD, Gonzalez MA, Weissman G, Li Y, Goldstein SA, et al. Correlates and causes of death in patients with severe symptomatic aortic stenosis who are not eligible to participate in a clinical trial of transcatheter aortic valve implantation. Circulation 2010;122(11):37-42. [DOI: 10.1161/CIRCULATIONAHA.109.926873] - DOI - PubMed
Borregaard 2019
    1. Borregaard B, Dahl JS, Riber LPS, Ekholm O, Sibilitz KL, Weiss M, et al. Effect of early, individualised and intensified follow-up after open heart valve surgery on unplanned cardiac hospital readmissions and all-cause mortality. International Journal of Cardiology 2019;15(289):30-6 [Epub 2019 Apr 11]. [DOI: 10.1016/j.ijcard.2019.02.056] - DOI - PubMed
Boutron 2008
    1. Boutron I, Moher D, Altman DG, Schultz KF, Ravaud P, CONSORT Group. Extending the CONSORT statement to randomized trials of nonpharmacologic treatment: explanation and elaboration. Annals of Internal Medicine 2008;148(4):295-309. - PubMed
Butchart 2005
    1. Butchart EG, Gohlke-Bärwolf C, Antunes MJ, Tornos P, Caterina RD, Cormier B, et al. Recommendations for the management of patients after heart valve surgery. European Heart Journal 2005;26:2463–71. - PubMed
Clausen 1976
    1. Clausen JP, Trap-Jensen J. Heart rate and arterial blood pressure during exercise in patients with angina pectoris: effects of exercise training and of nitroglycerin. Circulation 1976;53:436-42. - PubMed
Corra 2010
    1. European Association of Cardiovascular Prevention and Rehabilitation Committee for Science Guidelines, EACPR, Corrà U, Piepoli MF, Carré F, Heuschmann P, Hoffmann U, et al. Secondary prevention through cardiac rehabilitation: physical activity counselling and exercise training: key components of the position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation. European Heart Journal 2014;31(16):1967-74. [PMID: ] - PubMed
Frank 1973
    1. Frank S, Johnson A, Ross J. Natural history of valvular aortic stenosis. British Heart Journal 1973;35:41-6. - PMC - PubMed
Fredericks 2012
    1. Fredericks S, Lapum J, Lo J. Anxiety, depression, and self-management: a systematic review. Clinical Nursing Research 2012;21(4):411-30. [DOI: 10.1177/1054773812436681] - DOI - PubMed
Furukawa 2006
    1. Furukawa TA, Barbuib C, Ciprianib A, Brambillac P, Watanabe N. Imputing missing standard deviations in meta-analyses can provide accurate results. Journal of Clinical Epidemiology 2006;59:7–10. [DOI: 10.1016/j.jclinepi.2005.06.006] - DOI - PubMed
Gianuzzi 2003
    1. Giannuzzi P, Mezzani A, Saner H, Björnstad H, Fioretti P, Mendes M, et al. Physical activity for primary and secondary prevention. Position paper of the Working Group on Cardiac Rehabilitation and Exercise Physiology of the European Society of Cardiology. European Journal of Cardiovascular Prevention & Rehabilitation 2003;10:319–27. [DOI: 10.1097/01.hjr.0000086303.28200.50] - DOI - PubMed
Gohlke‐Bärwolf 1992
    1. Gohlke-Bärwolf C, Gohlke H, Samek L, Peters K, Betz P, Eschenbruch E, et al. Exercise tolerance and working capacity after valve replacement. Journal of Heart Valve Disease 1992;1(2):189-95. [PMID: ] - PubMed
GradePro Software [Computer program]
    1. GRADEpro GDT: GRADEpro Guideline Development Tool [Software]. GRADEpro, 2015 (developed by Evidence Prime, Inc.).
Hambrecht 2000
    1. Hambrecht R, Gielen S, Linke A, Fiehn E, Yu J, Walther C, et al. Effects of exercise training on left ventricular function and peripheral resistance in patients with chronic heart failure: a randomised trial. JAMA 2000;283(23):3095–101. - PubMed
Hansen 2009
    1. Hansen L, Winkel S, Kuhr J, Bader R, Bleese N, Riess F-C. Factors influencing survival and postoperative quality of life after mitral valve reconstruction. European Journal of Cardio-Thoracic Surgery 2010;37:635-44. [DOI: 10.1016/j.ejcts.2009.07.044] - DOI - PubMed
Hansen 2017
    1. Hansen TB, Zwisler AD, Berg SK, et al. Cost-utility analysis of cardiac rehabilitation after conventional heart valve surgery versus usual care. European Journal of Preventive Cardiology 2017;24:698–707. [DOI: 10.1177/2047487317689908] - DOI - PubMed
Higgins 2019a
    1. Higgins JP, Savović J, Page MJ, Elbers RG, Sterne JA. Chapter 8. Assessing risk of bias in a randomized trial. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.0 (updated July 2019). Cochrane 2019. Available from www.training.cochrane.org/handbook.
Higgins 2019b
    1. Higgins JP, Li T, Deeks JJ (editors). Chapter 6. Choosing effect measures and computing estimates of effect. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.0 (updated July 2019). Cochrane 2019. Available from www.training.cochrane.org/handbook.
Higgins 2019c
    1. Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.0 (updated July 2019). Cochrane 2019. Version 6. Available from www.training.cochrane.org/handbook.
Iung 2003
    1. Iung B, Baron G, Butchart EG, Delahaye F, Gohlke-Bärwolf C, Levang OW, et al. A prospective survey of patients with valvular heart disease in Europe: the Euro Heart Survey on Valvular Heart Disease. European Heart Journal 2003;24:1231-43. [DOI: 10.1016/S0195-668X(03)00201-X] - DOI - PubMed
Karlsson 2010
    1. Karlsson AK, Mattson B, Johansson M, Lidell E. Well-being in patients and relatives after open-heart surgery from the perspective of health care professionals. Journal of Clinical Nursing 2010;19:840-6. [DOI: 10.1111/j.1365-2702.2009.03017.x] - DOI - PubMed
Kiel 2011
    1. Kiel MK. Cardiac rehabilitation after heart valve surgery. Journal of Injury, Function and Rehabilitation 2011;3(10):962-7. [DOI: 10.1016/j.pmrj.2011.06.007] - DOI - PubMed
Kolte 2019
    1. Kolte D, Vlahakes GJ, Palacios IF, Sakhuja R, Passeri JJ, Inglessis I, et al. Transcatheter versus surgical aortic valve replacement in low-risk patients. Journal of the American College of Cardiology 2019;74:1532-40. - PubMed
Landry 1984
    1. Landry F, Habel C, Desaulniers D, Dagenais GR, Moisan A, Cote L. Vigorous physical training after aortic valve replacement: analysis of 10 patients. American Journal of Cardiology 1984;53(4):562-6. [PMID: ] - PubMed
Lauck 2020
    1. Lauck SB, Arnold SV, Borregaard B, Sathananthan J, Humphries KH, Baron SJ, et al, 3M TAVR Investigators. Very early changes in quality of life after transcatheter aortic valve replacement: results from the 3M TAVR trial. Cardiovascular Revascularization Medicine 2020;S1553-8389(20):30349-3. [DOI: 10.1016/j.carrev.2020.05.044] - DOI - PubMed
Lefebvre 2011
    1. Lefebvre C, Manheimer E, Glanville J. Chapter 6. Searching for studies. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
Long 2019
    1. Long L, Mordi IR, Bridges C, Sagar VA, Davies EJ, Coats AJS, et al. Exercise‐based cardiac rehabilitation for adults with heart failure. Cochrane Database of Systematic Reviews 2019, Issue 1. Art. No: CD003331. [DOI: 10.1002/14651858.CD003331.pub5] - DOI - PMC - PubMed
Mack 2019
    1. Mack MJ, Leon MB, Thourani VH, Makkar R, Kodali SK, Russo M, et al. Transcatheter aortic-valve replacement with a balloon-expandable valve in low-risk patients. New England Journal of Medicine 2019;380:1695-705. - PubMed
Nishimura 2014
    1. Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin III JP, Guyton RA, et al. 2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2014;129:2440-92. [DOI: 10.1161/CIR.0000000000000029] - DOI - PubMed
Nkomo 2006
    1. Nkomo VT, Gardin JM, Skelton TN, Gottdiener JS, Scott CG, Enriquez-Sarano M. Burden of valvular heart diseases: a population-based study. Lancet 2006;368(9540):1005-11. - PubMed
Pardaens 2014
    1. Pardaens S, Moerman V, Willems AM, Calders P, Bartunek J, Vanderheyden M, et al. Impact of the preoperative risk and the type of surgery on exercise capacity and training after valvular surgery. American Journal of Cardiology 2014;113(8):1383-9. [DOI: 10.1016/j.amjcard.2014.01.413] - DOI - PubMed
Pavy 2006
    1. Pavy B, Iliou MC, Meurin P, Tabet JY, Corone S. Safety of exercise training for cardiac patients: results of the French registry of complications during cardiac rehabilitation. Archives of Internal Medicine 2006;166(21):2329-34. [PMID: ] - PubMed
Piepoli 2010
    1. Piepoli MF, Corra U, Benzer W, Bjarnason-Wehrens B, Dendale P, Gaita D, et al. Secondary prevention through cardiac rehabilitation: from knowledge to implementation. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation. European Journal of Cardiovascular Prevention & Rehabilitation 2010;17(1):1-17. [DOI: 10.1097/HJR.0b013e3283313592] - DOI - PubMed
Popma 2019
    1. Popma JJ, Deeb GM, Yakubov SJ, Mumtaz M, Gada H, O'Hair D, et al. Transcatheter aortic-valve replacement with a self-expanding valve in low-risk patients. New England Journal of Medicine 2019;380:1706-15. - PubMed
Pressler 2018
    1. Pressler A, Forschner L, Hummel J, et al. Long-term effect of exercise training in patients after transcatheter aortic valve implantation: follow-up of the SPORT:TAVI randomised pilot study. European Journal of Preventative Cardiology 2018;25(8):794-801. - PubMed
RevMan 2020 [Computer program]
    1. Review Manager (RevMan). Version 5.4. The Cochrane Collaboration, May 2020.
Ribeiro 2017
    1. Ribeiro GS, Melo RD, Deresz LF, Dal Lago P, Pontes MR, Karsten M. Cardiac rehabilitation programme after transcatheter aortic valve implantation versus surgical aortic valve replacement: systematic review and meta-analysis. European Journal of Preventive Cardiology 2017;24:688-97. - PubMed
Schünemann 2013
    1. Schünemann H, Brożek J, Guyatt G, Oxman A, editors. GRADE handbook for grading quality of evidence and strength of recommendations. Updated October 2013. The GRADE Working Group, 2013. Available from guidelinedevelopment.org/handbook.
Sibilitz 2015
    1. Sibilitz K, Berg S, Hansen T, et al. Update to the trial protocol, including statistical analysis plan for a randomized clinical trial comparing comprehensive cardiac rehabilitation after heart valve surgery with control: the CopenHeart VR trial. Trials 2015;16:38. - PMC - PubMed
Sibilitz 2015a
    1. Sibilitz KL, Berg SK, Thygesen LC, Hansen TB, Køber L, Hassager C, et al. High readmission rate after heart valve surgery: a nationwide cohort study. International Journal of Cardiology 2015;189:96-104. [DOI: 10.1016/j.ijcard.2015.04.078] - DOI - PubMed
Sibilitz 2016 SR
    1. Sibilitz KL, Berg SK, Tang LH, Risom SS, Gluud C, Lindschou J, et al. Exercise‐based cardiac rehabilitation for adults after heart valve surgery. Cochrane Database of Systematic Reviews 2016;Issue 3:Art. No.: CD010876. [DOI: 10.1002/14651858.CD010876.pub2] - DOI - PubMed
Smart 2018
    1. Smart NA, King N, Lambert JD, et al. Exercise based cardiac rehabilitation improves exercise capacity and health-related quality of life in participants with atrial fibrillation: a systematic review and meta-analysis of randomised and non-randomised trials. Open Heart 2018;5:e000880. [DOI: 10.1136/openhrt-2018-000880] - DOI - PMC - PubMed
Sterne 2011
    1. Sterne JAC, Egger M, Moher D. Chapter 10. Addressing reporting biases. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
Sterne 2019
    1. Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ 2019;366:l4898. [DOI: ] - PubMed
Supino 2006
    1. Supino PG, Borer JS, Preibisz J, Bornstein A. The epidemiology of valvular heart disease: a growing public health problem. Heart Failure Clinics 2006;2(4):379-93. - PubMed
Thompson 2002
    1. Thompson SG, Higgens JP. How should meta-regression analyses be undertaken and interpreted? Statistics in Medicine 2002;21(11):1559-73. [PMID: ] - PubMed
Vahanian 2012
    1. Vahanian A, Alfieri O, Andreotti F, Antunes MJ, Baron-Esquivias G, Baumgartner H, et al. Guidelines on the management of valvular heart disease: the Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the Eurpoean Association for Cardio-Thoracic Surgery (EACTS). European Heart Journal 2012;33(19):2451-96. [DOI: 10.1093/eurheartj/ehs109] - DOI - PubMed
Whalley 2011
    1. Whalley B, Rees K, Davies P, Bennett P, Ebrahim S, Liu Z, et al. Psychological interventions for coronary heart disease. Cochrane Database of Systematic Reviews 2011, Issue 8. Art. No: CD002902. [DOI: 10.1002/14651858.CD002902.pub3] - DOI - PubMed
Wood 2008
    1. Wood L, Egger M, Gluud LL, Schulz KF, Jüni P, Altman DG, et al. Empirical evidence of bias in treatment effect estimates in controlled trials with different interventions and outcomes: meta-epidemiological study. BMJ 2008;336(7644):601-5. [DOI: ] - PMC - PubMed
Yagdir 2020
    1. Yadgir S, Johnson CO, Aboyans V, et al. Global, regional, and national burden of calcific aortic valve and degenerative mitral valve diseases, 1990-2017. Circulation 2020;121:1670–80. [DOI: 10.1161/CIRCULATIONAHA.119.043391] [PMID: PMID: 32223336] - DOI - PubMed

References to other published versions of this review

Sibilitz 2013b
    1. Sibilitz KL, Berg SK, Tang LH, Risom SS, Gluud C, Lindschou J, et al. Exercise-based cardiac rehabilitation for adults after heart valve surgery. Cochrane Database of Systematic Reviews 2013, Issue 12. Art. No: CD010876. [DOI: 10.1002/14651858.CD010876] - DOI - PubMed

Publication types

Associated data