Application progress of pre-rehabilitation in patients undergoing transcatheter aortic valve replacement_West China Medical Journal

Authors：

HE Yaxie ¹ , XIAO Li ^1,2 , CHEN Mengshi ¹ , SU Yushuang ¹ ,  YANG Qin ^1,3

1. School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, P. R. China;
2. Department of Geriatric Cardiology, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu, Sichuan 610072, P. R. China;
3. Department of Intensive Care Units, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu, Sichuan 610072, P. R. China;

Corresponding?author：

YANG Qin, Email: 20152160@qq.com

Keywords：

Pre-rehabilitation; transcatheter aortic valve replacement; preoperative management

DOI：

10.7507/1002-0179.202402029

Video：

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Abstract Full text Figures/Tables Video References Cited by

Pre-rehabilitation is an emerging preoperative management strategy designed to mitigate surgical stress responses and expedite postoperative recovery through optimized interventions, which typically includes exercise training, nutritional support, and psychological counseling. For patients undergoing transcatheter aortic valve replacement (TAVR), the implementation of pre-rehabilitation measures is particularly crucial. This article reviews the necessity and principal components of pre-rehabilitation in TAVR patients, and offers suggestions including constructing the best pre-rehabilitation intervention program for TAVR, enhancing patient compliance and engagement in the recovery process, and paying attention to the management of frailty for TAVR patients. The aim is to provide a reference for healthcare professionals seeking to further refine the pre-rehabilitation management model for TAVR patients.

Citation： HE Yaxie, XIAO Li, CHEN Mengshi, SU Yushuang, YANG Qin. Application progress of pre-rehabilitation in patients undergoing transcatheter aortic valve replacement. West China Medical Journal, 2024, 39(6): 970-975. doi: 10.7507/1002-0179.202402029 Copy

1.	Yang Y, Wang Z, Chen Z, et al. Current status and etiology of valvular heart disease in China: a population-based survey. BMC Cardiovasc Disord, 2021, 21(1): 339.
2.	中國醫師協會心血管內科醫師分會結構性心臟病專業委員, 中華醫學會心血管病學分會結構性心臟病學組. 經導管主動脈瓣置換術中國專家共識. 中國介入心臟病學雜志, 2015, 23(12): 661-667.
3.	毛越, 徐劍鋒, 李梅, 等. 經導管主動脈瓣置換術患者Ⅰ期心臟康復的最佳證據應用. 中華護理雜志, 2022, 57(5): 563-569.
4.	Steinmetz C, Bjarnason-Wehrens B, Walther T, et al. Efficacy of prehabilitation before cardiac surgery: a systematic review and meta-analysis. Am J Phys Med Rehabil, 2023, 102(4): 323-330.
5.	Marmelo F, Rocha V, Moreira-Gon?alves D. The impact of prehabilitation on post-surgical complications in patients undergoing non-urgent cardiovascular surgical intervention: systematic review and meta-analysis. Eur J Prev Cardiol, 2018, 25(4): 404-417.
6.	曹暉, 陳亞進, 顧小萍, 等. 中國加速康復外科臨床實踐指南(2021 版). 中國實用外科雜志, 2021, 41(9): 961-992.
7.	Li C, Carli F, Lee L, et al. Impact of a trimodal prehabilitation program on functional recovery after colorectal cancer surgery: a pilot study. Surg Endosc, 2013, 27(4): 1072-1082.
8.	梁詩琪, 李婷婷, 任秋平, 等. 基于 ERAS 理念的預康復在腹部大手術病人中的應用研究進展. 護理研究, 2023, 37(18): 3335-3343.
9.	Afilalo J, Lauck S, Kim DH, et al. Frailty in older adults undergoing aortic valve replacement: the FRAILTY-AVR study. J Am Coll Cardiol, 2017, 70(6): 689-700.
10.	Komaki K, Yoshida N, Satomi-Kobayashi S, et al. Preoperative frailty affects postoperative complications, exercise capacity, and home discharge rates after surgical and transcatheter aortic valve replacement. Heart Vessels, 2021, 36(8): 1234-1245.
11.	Baimas-George M, Watson M, Elhage S, et al. Prehabilitation in frail surgical patients: a systematic review. World J Surg, 2020, 44(11): 3668-3678.
12.	中國醫師協會心血管內科醫師分會結構性心臟病專業委員會. 經導管主動脈瓣置換術后運動康復專家共識. 中國介入心臟病學雜志, 2020, 28(7): 361-368.
13.	Arora RC, Brown CH 4th, Sanjanwala RM, et al. “NEW” prehabilitation: a 3-way approach to improve postoperative survival and health-related quality of life in cardiac surgery patients. Can J Cardiol, 2018, 34(7): 839-849.
14.	沈佩燁, 蘭嵐, 王佳琪, 等. 老年心臟手術患者住院期間功能下降評估及影響因素研究進展. 中華護理雜志, 2023, 58(19): 2345-2352.
15.	DeCato TW, Haverkamp H, Hegewald MJ. Cardiopulmonary Exercise Testing (CPET). Am J Respir Crit Care Med, 2020, 201(1): P1-P2.
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19.	Rogers P, Al-Aidrous S, Banya W, 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 Feasibility Stud, 2018, 4: 185.
20.	池蕾娟, 劉宏軍, 楊超君, 等. 高強度間歇運動在急性冠狀動脈綜合征患者心臟康復中的研究進展. 中國醫學科學院學報, 2023, 45(1): 149-154.
21.	羅澤汝心, 王渝強, 周亞馨, 等. 術前吸氣肌訓練預防成人心臟手術患者術后肺部并發癥的最新進展. 中國胸心血管外科臨床雜志, 2023, 30(10): 1519-1523.
22.	Bull FC, Al-Ansari SS, Biddle S, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med, 2020, 54(24): 1451-1462.
23.	Zheng YT, Zhang JX. Preoperative exercise and recovery after cardiac surgery: a meta-analysis. BMC Cardiovasc Disord, 2020, 20(1): 2.
24.	Weber M, Klein U, Weigert A, et al. Use of pre- and intensified postprocedural physiotherapy in patients with symptomatic aortic stenosis undergoing transcatheter aortic valve replacement study (the 4P-TAVR Study). J Interv Cardiol, 2021, 2021: 8894223.
25.	Steinmetz C, Heinemann S, Kutschka I, et al. Prehabilitation in older patients prior to elective cardiac procedures (PRECOVERY): study protocol of a multicenter randomized controlled trial. Trials, 2023, 24(1): 533.
26.	張臨雪, 周家梅, 王菲, 等. 心臟手術病人術前衰弱評估與干預研究進展. 護理研究, 2023, 37(3): 449-454.
27.	Chermesh I, Hajos J, Mashiach T, et al. Malnutrition in cardiac surgery: food for thought. Eur J Prev Cardiol, 2014, 21(4): 475-483.
28.	Morimoto Y, Matsuo T, Yano Y, et al. Impact of sarcopenia on the progress of cardiac rehabilitation and discharge destination after cardiovascular surgery. J Phys Ther Sci, 2021, 33(3): 213-221.
29.	Jain SR, Kandarpa VL, Yaow CYL, et al. The role and effect of multimodal prehabilitation before major abdominal surgery: a systemic review and meta-analysis. World J Surg, 2023, 47(1): 86-102.
30.	陳麗芳, 曾潔文, 黃蓮香, 等. 心臟瓣膜置換術后病人實施三聯預康復的效果觀察. 循證護理, 2023, 9(9): 1685-1688.
31.	吳春濤, 劉蘇, 唐閩, 等. 心臟瓣膜病病人營養風險篩查及營養支持與術后臨床結局的相關性分析. 腸外與腸內營養, 2019, 26(2): 104-108.
32.	Stratton RJ, Hackston A, Longmore D, et al. Malnutrition in hospital outpatients and inpatients: prevalence, concurrent validity and ease of use of the ‘malnutrition universal screening tool’ (‘MUST’) for adults. Br J Nutr, 2004, 92(5): 799-808.
33.	Lomivorotov VV, Efremov SM, Boboshko VA, et al. Evaluation of nutritional screening tools for patients scheduled for cardiac surgery. Nutrition, 2013, 29(2): 436-442.
34.	Stoppe C, Goetzenich A, Whitman G, et al. Role of nutrition support in adult cardiac surgery: a consensus statement from an International Multidisciplinary Expert Group on Nutrition in Cardiac Surgery. Crit Care, 2017, 21(1): 131.
35.	葉紹東, 陳紀春, 劉鵬舉, 等. 中國高齡患者心臟圍術期營養評估專家共識. 中華老年心腦血管病雜志, 2023, 25(4): 361-367.
36.	Hoffer LJ, Bistrian BR. Appropriate protein provision in critical illness: a systematic and narrative review. Am J Clin Nutr, 2012, 96(3): 591-600.
37.	Chiang FY, Chen JR, Lee WJ, et al. Effects of milk or soy milk combined with mild resistance exercise on the muscle mass and muscle strength in very old nursing home residents with sarcopenia. Foods, 2021, 10(11): 2581.
38.	Zou J, Yuan J, Liu J, Geng Q. Impact of cardiac rehabilitation on pre- and post-operative transcatheter aortic valve replacement prognoses. Front Cardiovasc Med, 2023, 10: 1164104.
39.	Goldfarb M, Lauck S, Webb JG, et al. Malnutrition and mortality in frail and non-frail older adults undergoing aortic valve replacement. Circulation, 2018, 138(20): 2202-2211.
40.	周雁榮, 張嚴麗, 羅亮春, 等. 敘事護理干預對心臟瓣膜置換術患者心理狀態的影響. 護理學雜志, 2020, 35(21): 81-84.
41.	孫振曉, 劉化學, 焦林瑛, 等. 醫院焦慮抑郁量表的信度及效度研究. 中華臨床醫師雜志(電子版), 2017, 11(2): 198-201.
42.	陳燕. 基于 5E 理念的預康復在心臟瓣膜置換術患者中的應用. 河南外科學雜志, 2021, 27(3): 103-104.
43.	劉然, 嚴婷婷, 陳琪, 等. 行經導管主動脈瓣置換術的主動脈瓣狹窄患者心臟康復實踐與探索. 中國胸心血管外科臨床雜志, 2022, 29(12): 1567-1573.
44.	劉子嘉, 張路, 劉洪生, 等. 基于加速術后康復的胸外科手術預康復管理專家共識(2022). 協和醫學雜志, 2022, 13(3): 387-401.
45.	Naccarella L, Biuso C, Jennings A, et al. Improving access to important recovery information for heart patients with low health literacy: reflections on practice-based initiatives. Aust Health Rev, 2019, 43(3): 323-327.
46.	馬富珍, 劉長芬, 鄭棟蓮, 等. 心臟瓣膜置換術后患者Ⅰ期康復運動恐懼現狀及影響因素分析. 當代護士(中旬刊), 2022, 29(10): 130-133.
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48.	Marinus N, Vigorito C, Giallauria F, et al. Frailty is highly prevalent in specific cardiovascular diseases and females, but significantly worsens prognosis in all affected patients: a systematic review. Ageing Res Rev, 2021, 66: 101233.
49.	Hall DE, Arya S, Schmid KK, et al. Association of a frailty screening initiative with postoperative survival at 30, 180, and 365 days. JAMA Surg, 2017, 152(3): 233-240.
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1. Yang Y, Wang Z, Chen Z, et al. Current status and etiology of valvular heart disease in China: a population-based survey. BMC Cardiovasc Disord, 2021, 21(1): 339.
2. 中國醫師協會心血管內科醫師分會結構性心臟病專業委員, 中華醫學會心血管病學分會結構性心臟病學組. 經導管主動脈瓣置換術中國專家共識. 中國介入心臟病學雜志, 2015, 23(12): 661-667.
3. 毛越, 徐劍鋒, 李梅, 等. 經導管主動脈瓣置換術患者Ⅰ期心臟康復的最佳證據應用. 中華護理雜志, 2022, 57(5): 563-569.
4. Steinmetz C, Bjarnason-Wehrens B, Walther T, et al. Efficacy of prehabilitation before cardiac surgery: a systematic review and meta-analysis. Am J Phys Med Rehabil, 2023, 102(4): 323-330.
5. Marmelo F, Rocha V, Moreira-Gon?alves D. The impact of prehabilitation on post-surgical complications in patients undergoing non-urgent cardiovascular surgical intervention: systematic review and meta-analysis. Eur J Prev Cardiol, 2018, 25(4): 404-417.
6. 曹暉, 陳亞進, 顧小萍, 等. 中國加速康復外科臨床實踐指南(2021 版). 中國實用外科雜志, 2021, 41(9): 961-992.
7. Li C, Carli F, Lee L, et al. Impact of a trimodal prehabilitation program on functional recovery after colorectal cancer surgery: a pilot study. Surg Endosc, 2013, 27(4): 1072-1082.
8. 梁詩琪, 李婷婷, 任秋平, 等. 基于 ERAS 理念的預康復在腹部大手術病人中的應用研究進展. 護理研究, 2023, 37(18): 3335-3343.
9. Afilalo J, Lauck S, Kim DH, et al. Frailty in older adults undergoing aortic valve replacement: the FRAILTY-AVR study. J Am Coll Cardiol, 2017, 70(6): 689-700.
10. Komaki K, Yoshida N, Satomi-Kobayashi S, et al. Preoperative frailty affects postoperative complications, exercise capacity, and home discharge rates after surgical and transcatheter aortic valve replacement. Heart Vessels, 2021, 36(8): 1234-1245.
11. Baimas-George M, Watson M, Elhage S, et al. Prehabilitation in frail surgical patients: a systematic review. World J Surg, 2020, 44(11): 3668-3678.
12. 中國醫師協會心血管內科醫師分會結構性心臟病專業委員會. 經導管主動脈瓣置換術后運動康復專家共識. 中國介入心臟病學雜志, 2020, 28(7): 361-368.
13. Arora RC, Brown CH 4th, Sanjanwala RM, et al. “NEW” prehabilitation: a 3-way approach to improve postoperative survival and health-related quality of life in cardiac surgery patients. Can J Cardiol, 2018, 34(7): 839-849.
14. 沈佩燁, 蘭嵐, 王佳琪, 等. 老年心臟手術患者住院期間功能下降評估及影響因素研究進展. 中華護理雜志, 2023, 58(19): 2345-2352.
15. DeCato TW, Haverkamp H, Hegewald MJ. Cardiopulmonary Exercise Testing (CPET). Am J Respir Crit Care Med, 2020, 201(1): P1-P2.
16. 《運動處方中國專家共識(2023)》專家組. 運動處方中國專家共識(2023). 中國運動醫學雜志, 2023, 42(1): 3-13.
17. 劉佳霓, 李翔, 陳茂. 《經導管主動脈瓣置換術后運動康復專家共識》解讀. 華西醫學, 2021, 36(9): 1196-1200.
18. Scheede-Bergdahl C, Minnella EM, Carli F. Multi-modal prehabilitation: addressing the why, when, what, how, who and where next?. Anaesthesia, 2019, 74(Suppl 1): 20-26.
19. Rogers P, Al-Aidrous S, Banya W, 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 Feasibility Stud, 2018, 4: 185.
20. 池蕾娟, 劉宏軍, 楊超君, 等. 高強度間歇運動在急性冠狀動脈綜合征患者心臟康復中的研究進展. 中國醫學科學院學報, 2023, 45(1): 149-154.
21. 羅澤汝心, 王渝強, 周亞馨, 等. 術前吸氣肌訓練預防成人心臟手術患者術后肺部并發癥的最新進展. 中國胸心血管外科臨床雜志, 2023, 30(10): 1519-1523.
22. Bull FC, Al-Ansari SS, Biddle S, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med, 2020, 54(24): 1451-1462.
23. Zheng YT, Zhang JX. Preoperative exercise and recovery after cardiac surgery: a meta-analysis. BMC Cardiovasc Disord, 2020, 20(1): 2.
24. Weber M, Klein U, Weigert A, et al. Use of pre- and intensified postprocedural physiotherapy in patients with symptomatic aortic stenosis undergoing transcatheter aortic valve replacement study (the 4P-TAVR Study). J Interv Cardiol, 2021, 2021: 8894223.
25. Steinmetz C, Heinemann S, Kutschka I, et al. Prehabilitation in older patients prior to elective cardiac procedures (PRECOVERY): study protocol of a multicenter randomized controlled trial. Trials, 2023, 24(1): 533.
26. 張臨雪, 周家梅, 王菲, 等. 心臟手術病人術前衰弱評估與干預研究進展. 護理研究, 2023, 37(3): 449-454.
27. Chermesh I, Hajos J, Mashiach T, et al. Malnutrition in cardiac surgery: food for thought. Eur J Prev Cardiol, 2014, 21(4): 475-483.
28. Morimoto Y, Matsuo T, Yano Y, et al. Impact of sarcopenia on the progress of cardiac rehabilitation and discharge destination after cardiovascular surgery. J Phys Ther Sci, 2021, 33(3): 213-221.
29. Jain SR, Kandarpa VL, Yaow CYL, et al. The role and effect of multimodal prehabilitation before major abdominal surgery: a systemic review and meta-analysis. World J Surg, 2023, 47(1): 86-102.
30. 陳麗芳, 曾潔文, 黃蓮香, 等. 心臟瓣膜置換術后病人實施三聯預康復的效果觀察. 循證護理, 2023, 9(9): 1685-1688.
31. 吳春濤, 劉蘇, 唐閩, 等. 心臟瓣膜病病人營養風險篩查及營養支持與術后臨床結局的相關性分析. 腸外與腸內營養, 2019, 26(2): 104-108.
32. Stratton RJ, Hackston A, Longmore D, et al. Malnutrition in hospital outpatients and inpatients: prevalence, concurrent validity and ease of use of the ‘malnutrition universal screening tool’ (‘MUST’) for adults. Br J Nutr, 2004, 92(5): 799-808.
33. Lomivorotov VV, Efremov SM, Boboshko VA, et al. Evaluation of nutritional screening tools for patients scheduled for cardiac surgery. Nutrition, 2013, 29(2): 436-442.
34. Stoppe C, Goetzenich A, Whitman G, et al. Role of nutrition support in adult cardiac surgery: a consensus statement from an International Multidisciplinary Expert Group on Nutrition in Cardiac Surgery. Crit Care, 2017, 21(1): 131.
35. 葉紹東, 陳紀春, 劉鵬舉, 等. 中國高齡患者心臟圍術期營養評估專家共識. 中華老年心腦血管病雜志, 2023, 25(4): 361-367.
36. Hoffer LJ, Bistrian BR. Appropriate protein provision in critical illness: a systematic and narrative review. Am J Clin Nutr, 2012, 96(3): 591-600.
37. Chiang FY, Chen JR, Lee WJ, et al. Effects of milk or soy milk combined with mild resistance exercise on the muscle mass and muscle strength in very old nursing home residents with sarcopenia. Foods, 2021, 10(11): 2581.
38. Zou J, Yuan J, Liu J, Geng Q. Impact of cardiac rehabilitation on pre- and post-operative transcatheter aortic valve replacement prognoses. Front Cardiovasc Med, 2023, 10: 1164104.
39. Goldfarb M, Lauck S, Webb JG, et al. Malnutrition and mortality in frail and non-frail older adults undergoing aortic valve replacement. Circulation, 2018, 138(20): 2202-2211.
40. 周雁榮, 張嚴麗, 羅亮春, 等. 敘事護理干預對心臟瓣膜置換術患者心理狀態的影響. 護理學雜志, 2020, 35(21): 81-84.
41. 孫振曉, 劉化學, 焦林瑛, 等. 醫院焦慮抑郁量表的信度及效度研究. 中華臨床醫師雜志(電子版), 2017, 11(2): 198-201.
42. 陳燕. 基于 5E 理念的預康復在心臟瓣膜置換術患者中的應用. 河南外科學雜志, 2021, 27(3): 103-104.
43. 劉然, 嚴婷婷, 陳琪, 等. 行經導管主動脈瓣置換術的主動脈瓣狹窄患者心臟康復實踐與探索. 中國胸心血管外科臨床雜志, 2022, 29(12): 1567-1573.
44. 劉子嘉, 張路, 劉洪生, 等. 基于加速術后康復的胸外科手術預康復管理專家共識(2022). 協和醫學雜志, 2022, 13(3): 387-401.
45. Naccarella L, Biuso C, Jennings A, et al. Improving access to important recovery information for heart patients with low health literacy: reflections on practice-based initiatives. Aust Health Rev, 2019, 43(3): 323-327.
46. 馬富珍, 劉長芬, 鄭棟蓮, 等. 心臟瓣膜置換術后患者Ⅰ期康復運動恐懼現狀及影響因素分析. 當代護士(中旬刊), 2022, 29(10): 130-133.
47. Hawkins MA, Dolansky MA, Levin JB, et al. Cognitive function and health literacy are independently associated with heart failure knowledge. Heart Lung, 2016, 45(5): 386-391.
48. Marinus N, Vigorito C, Giallauria F, et al. Frailty is highly prevalent in specific cardiovascular diseases and females, but significantly worsens prognosis in all affected patients: a systematic review. Ageing Res Rev, 2021, 66: 101233.
49. Hall DE, Arya S, Schmid KK, et al. Association of a frailty screening initiative with postoperative survival at 30, 180, and 365 days. JAMA Surg, 2017, 152(3): 233-240.
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