Outpatient Cardiac Rehabilitation After Minimally Invasive Heart Surgery

Minimally invasive cardiac surgery and cardiac minimally invasive treatment are becoming more popular.

In recent years, minimally invasive cardiac surgery called minimally invasive cardiac surgery (MICS) has become popular in Okinawa Prefecture (and nationwide).¹. Transcatheter aortic valve replacement (TAVR) for aortic valve stenosis is also becoming more popular.³. Patients are examined on an outpatient basis after these minimally invasive treatments, but the time until discharge from hospital is shorter than with median sternotomy.², I find that I can return to my daily life very quickly. It has also been reported that cardiac rehabilitation after MICS is more active than traditional median sternotomy.⁴. Although this is a good thing, I believe that hospitalization alone may not be enough for the cardiac rehabilitation period to have a rehabilitation effect on cardiac function.

Improvement in heart failure after MICS occurs after a while.

When examining patients after MICS-CABG or TAVR, I get the impression that improvement in cardiac function takes a while. As minimally invasive cardiac surgery becomes more widespread, we believe that the need for cardiac rehabilitation during the subacute recovery period will increase in the future. Cardiac rehabilitation, which used to be performed in the hospital, will now be transferred to outpatient settings. I would like to actively work on cardiac rehabilitation after MICS and TAVR.

Our clinic is looking for a physical therapist to work with us on cardiac rehabilitation.

References

1. https://j-mics.jp/greeting/
2. Kazuki Hisatomi, Takashi Miura, Kikuko Obase, Ichiro Matsumaru, Shun Nakaji, Akihiko Tanigawa, Shunsuke Taguchi, Masayuki Takura, Yuko Nakao, Kiyoyuki Eishi, Minimally Invasive Valvular Surgery in the Elderly - Safety, Early Recovery, and Long-Term Outcomes ―, Circulation Journal, 2022, Volume 86, Issue 11, p. 1725-1732
3. Yamamoto, M., Watanabe, Y., Tada, N., Naganuma, T., Araki, M., Yamanaka, F., Mizutani, K., Tabata, M., Ueno, H., Takagi, K., Higashimori, A., Shirai, S., Hayashida, K., & OCEAN-TAVI investigators. (2019). Transcatheter aortic valve replacement outcomes in Japan: Optimized CathEter vAlvular iNtervention (OCEAN) Japanese multicenter registry. Cardiovascular Revascularization Medicine: Including Molecular Interventions, 20(10), 843–851.
4. Nakajima, M., Totsugawa, T., Sakaguchi, T., Yuguchi, S., Matsuo, T., Ujikawa, T., Morisawa, T., & Takahashi, T. (2017). Changes in the amount of physical activity in minimally invasive cardiac surgery. Journal of Physical Therapy Science, 29(11), 2035–2038.