Early care before heart surgery reduces complications later

Heart patients requiring heart surgery are getting older these days and often face known risk factors such as smoking, obesity, anxiety, reduced lung strength and fitness. These factors increase the risk of adverse outcomes after surgery. It is known that advance guidance – pre-health – can improve a patient’s physical and mental fitness. However, the effect on the development of serious complications after heart surgery was still unclear. The Digital Cardiac Consultingstudy was the first in the world to study this. The impact of an innovative personalized program based on telemedicine was studied: in preparation for their operation, patients received remote care through an online audiovisual platform and guidance through expert consultations.

A digital platform
For this study, 394 patients were divided into two groups: 197 patients followed a personalized online pre-health program based on screening risk factors, 197 patients received standard care that included pre-operative care and rehabilitation after heart surgery. The guidance program was conducted through an online platform where patients could complete questionnaires and receive teleconsultations prior to their surgery – for at least six weeks. In addition, there were information and training modules on the platform about cardiovascular symptoms, smoking cessation, anxiety management, physical exercises, lung strength exercises and a diet program. After their surgery, all participants were examined three more times and closely monitored to prevent complications.

Reduction in heart problems
The research results showed two important but unknown facts; that postponing heart surgery for pre-health is safe and that the number of serious complications up to one year after surgery was significantly reduced in the pre-health group. There was a risk reduction of 8.8%, a 35% reduction compared to standard care. In addition to the reduction in the number of serious problems, patients in the pre-health group reported an improvement in lung strength, less anxiety and depression. Half of the smokers had quit smoking.

Routine care
Pretreatment is not yet standard care in cardiac surgery. The results from Digital Cardiac Counseling – a study There are reasons for this, according to heart surgeon and lead researcher of the study Peyman Sardari Nia: “Our results show that exercise as a secondary prevention can reduce the risk of serious complications after heart surgery . In addition, patients gain more ownership of their health in this way and are able to do something about it in their home environment. Therefore, rehabilitation would be a good addition to current postoperative rehabilitation programs for patients undergoing cardiac surgery.”

More information:
Effect of Teleprehabilitation on Adverse Events after Elective Cardiac Surgery: A Randomized Controlled Trial; Journal of the American College of Cardiology, JACC. October 11, 2024 https://www.jacc.org/doi/10.1016/j.jacc.2024.10.064