Usefulness of cardiac rehabilitation programs among older patients undergoing transcatheter aortic valve replacement:how should we do it?
摘要Severe aortic stenosis has increased exponentially as a result of the aging of the population.Transcatheter aortic valve replace-ment(TAVR)procedures increase by 20%-30%per year in Spain.Referred patients are increasingly older,have comorbidities,and frailty.TAVR cardiac rehabilitation(CR)programs significantly improve both functional capacity and quality of life of pa-tients.However,there are no guidelines on how to carry out them and few elderly patients are referred to CR.Furthermore,mor-tality in women who undergo TAVR is higher than in men and even fewer are referred to CR programs.Multidisciplinary pa-tient care,including comorbidities and frailty,is essential.It is necessary to ensure exquisite continuity of care during TAVR,CR,and the rest of the patient's life.Telerehabilitation could be an option in some lower-risk patients to include more patients in CR programs after TAVR,given the high demand.This article reviews the evidence on why CR should be performed in post-TAVR patients and proposes a practical and novel approach to the care process and the recommended aspects and components of the CR program.
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