ABSTRACT

Early Heart Rehabilitation Program Differences

In Patients with Post Heart Valve Replacement Surgery and Coronary Artery Bypass
Surgery – A Case Report

Aliana Trisuciwati, Derby Rosanno, M. Rachmat Sulthony

Patients with heart valve abnormality have different conditions compared to patients
with coronary heart disease where they will usually experience structural cardiac
abnormalities and declined cardiac function over several years, long before earliest symptoms
occur. Because of this particular reason, several studies have shown that post Heart Valve
Replacement Surgery (HVRS) patients will have a lower aerobic capacity
increment compared to post Coronary Artery Bypass Surgery (CABS) patients.

The purpose of this case report is to compare cardiac rehabilitation results in post
HVRS and post CABS patients. It was reported that a 22-year-old male with severe mitral
valve insufficiency, had undergone HVRS using mechanical mitral valve (MVR), and also
underwent rehabilitation phase II as many as 12 times, beginning with the previous 6MWT.
The results of this rehabilitation were then compared to a 68-year-old male patient who had
undergone CABS and had also undergone the same phase II cardiac rehabilitation process.

The initial 6MWT result in post MVR patient was 375 meters~7.5 METs, and then
repeated at the start of phase II cardiac rehabilitation with a distance of 475 meters~9.2
METs. At the end of phase II, a treadmill test was performed using Bruce protocol with 11
minutes~11.25 METs travel time.

The result of 6MWT I in post CABS patients was 250 meters~4 METs, 300
meters~4.8 METs in 6MWT II, and then the last test using treadmill test, the obtained travel
time was 10 minutes 34 seconds~6.81 METs.

Based on the results above, there was >10% mileage increase in each patient for the
6MWT I and 6MWT II, as well as equal significant enhancement of aerobic capacity in both
MVR (HVRS) and CABS patients.

Keyword: CABG, valve surgery, 6MWT, cardiac rehabilitation.