By Denise Williams
There’s Cardiac Rehabilitation…and there’s Cardiac Rehabilitation after transcatheter aortic valve replacement (TAVR). If you’re not sure how they’re unique, you won’t want to miss AACVPR’s upcoming live webcast on the topic.
The March 10 event features Dr. Hafiz Imran, MD, a teaching fellow in the cardiology division of Brown University’s Alpert School of Medicine. He notes that TAVR, which replaces a body's diseased aortic valve with an artificial aortic valve, is a relatively new procedure. It has been largely limited to frail patients in their 70s and 80s mostly, and sometimes in their 90s, who are at risk for procedural complications with conventional surgery.
Cardiac rehabilitation is recommended for patients who undergo TAVR just as it is for heart attack survivors and stent recipients. However, their older age, increased frailty, and limited functional capacity compared to traditional CR enrollees call for a gentler approach. “The goal of cardiac rehab is somewhat different in this set of patients than it would be for somebody who is younger or who receives a surgical aortic valve,” Imran explains. “We want to get [traditional cardiac rehab patients] in much better shape and optimize their lifestyle, but with the TAVR subset of the population, we just want to make them comfortable with the activities of daily living.” For example, the objective for an 80-year-old TAVR patient might be to turn the clock back 3-4 years in terms of functionality, so that he or she can move around within the home easily and perform grocery shopping and other tasks without tremendous difficulty.
As part of the upcoming webcast, Imran aims to increase understanding about the patient population that typically undergoes TAVR, which has been practiced in the United States for only about a decade. He will discuss how it has changed since then and what to expect in coming years. A widening in scope to include patients as young as 65 and a growing success rate with the procedure, for example, could signal greater numbers of enrollees in CR as well as healthier patients joining the programs.
The webcast also will examine strategies for assessing the functional capacity of CR participants at enrollment, how to slowly and gradually advance their exercise over time, and how their psycho-social health also changes with CR. Additionally, the talk will touch on the goals for overall improvement in day-to-day physical activity or exercise capacity after CR. Imran is also excited to review any alternative options or different kinds of CR programs that may now be available here, based on U.S. data.
Getting more information out about rehabilitation after TAVR is important, Imran emphasizes. “There are close to 1,000 programs all across the United States, but not a lot of people have taken advantage,” he says. “Certain centers and providers may not have that much experience or exposure, so webcasts and other educational opportunities would be a good exercise for these participants for when they do come across these patients.”
Dr. Imran’s free webcast, Cardiac Rehab after Transcatheter Aortic Valve Replacement, is scheduled for 12:00 p.m. CST on March 10. To register, click here.