TAVR: Less than one-third of patients enter cardiac rehab after heart procedure

The program is recommended by the Centers for Medicare and Medicaid services for patients who undergo heart valve repair or replacement

5:00 AM

Author | Noah Fromson

heart image drawing
Jacob Dwyer, Justine Ross, Michigan Medicine

The vast majority of people who have a minimally invasive heart valve replacement procedure do not participate in recommended cardiac rehabilitation, a Michigan Medicine-led study finds.

Researchers used clinical registry and health care claims data from over 3,300 patients who underwent transcatheter aortic valve replacement, or TAVR, in Michigan across 24 hospitals between 2016 and mid-2020, to determine the rate of cardiac rehabilitation participation and the factors associated with its utilization.

Results published in JACC: Advances reveal that just 30.6% of patients who underwent TAVR participated in cardiac rehabilitation within 90 days after discharge.

Patients who were older, more frail, smoked or had a history of common heart rhythm issues, like atrial fibrillation, were less likely to enter cardiac rehab.

Whether a patient participated in the medically supervised exercise and educational program varied substantially across 24 hospitals, ranging from 5 to 60%.

This variation across hospitals persisted despite accounting for differences in the characteristics of the patients treated at these hospitals.

The participation rate for cardiac rehab after TAVR was significantly lower than that for patients who had open-heart surgeries.

Researchers say the difference may be explained by TAVR patients being more frail or medically complex than patients who undergo surgical repair.

Investigators also note that patients may not receive the appropriate education regarding the importance of cardiac rehabilitation after this minimally invasive procedure.

“Cardiac rehabilitation has been shown to improve the quality of life for so many patients after cardiovascular procedures,” said first author Devraj Sukul, M.D., M.Sc., interventional cardiologist at the University of Michigan Health Frankel Cardiovascular Center and clinical assistant professor of internal medicine-cardiology at U-M Medical School.

“We found that the differences in participation between hospitals may be related to differences in the process each hospital takes after a patient undergoes TAVR. It is critical that we identify best practices to promote cardiac rehab participation to improve post-operative outcomes.”

Additional authors include Jeremy Albright, Ph.D., Michael P. Thompson, Ph.D., Alphonse DeLucia, M.D., Himanshu S. Patel, M.D., Stanley J. Chetcuti, M.D., and P. Michael Grossman, M.D., all of University of Michigan, Pedro Villablanca, M.D., and Steven J. Keteyian, Ph.D., both of Henry Ford Hospital, and Duane Berkompas, M.D., of Corewell Health.

Data for this study was sourced from the Michigan Structural Heart Consortium and the Michigan Value Collaborative, both of which are supported by Blue Cross Blue Shield of Michigan. However, the opinions, beliefs and viewpoints expressed by the authors do not necessarily reflect those of Blue Cross Blue Shield of any of its employees.

Paper cited: “Predictors and Variation in Cardiac Rehabilitation Participation After Transcatheter Aortic Valve Replacement,” JACC: Advances. DOI: 10.1016/j.jacadv.2023.100581


More Articles About: Transcatheter Aortic Valve Replacement (TAVR) Valve Repair and Replacement Cardiac Rehabilitation Cardiovascular: Diseases & Conditions Cardiovascular: Treatment & Surgery Heart disease
Health Lab word mark overlaying blue cells
Health Lab

Explore a variety of health care news & stories by visiting the Health Lab home page for more articles.

Related
person walking on treadmill
Health Lab
Cardiac rehabilitation reduces risk of death years after heart surgery, still underutilized
A Michigan Medicine study finds people who participate in cardiac rehabilitation have a decreased risk of death years after surgery, with a trend towards better outcomes in patients who attend more sessions.
Stay Informed

Want top health & research news weekly? Sign up for Health Lab’s newsletters today!

Subscribe
Featured News & Stories clinical team and patient standing together
Health Lab
Planting a tree, and hope, for a heart healthy future
A complex mitral valve repair by Michigan Medicine cardiac specialists helps restore health and happiness to one Michigan patient and his family.
surgeon dark room over surgery patient on hospital table
Health Lab
Women more likely than men to die after heart surgery complications
Despite having no greater chance of developing problems after high risk cardiovascular surgery, women are more likely than men to die from post-operative complications, a University of Michigan-led study suggests.
young adult man standin infront of welcome to michigan yellow sign and a photo next to that one of him sitting with a man standing next to him in glasses and UM badge and button down light blue shirt
Health Lab
Timely CPR saves runner who collapsed during first week of college
Bystander CPR saves a first year college student who collapsed from sudden cardiac arrest while running during his first week of school.
three students standing on stairs in Michigan shirts
Health Lab
From babies needing heart surgeries to Michigan Wolverines
After long congenital heart journeys at University of Michigan Health C.S. Mott Children’s Hospital and U-M Health West, three 2024 Grand Rapids area high school graduates are back at University of Michigan: this time, as official Michigan Wolverines.
Survival flight pilots and person standing by helicopter smiling
Health Lab
Motivational speaker reunites with Survival Flight nurses after sudden aortic dissection
A father and motivational speaker, who experienced an urgent heart problem, reunites with his Survival Flight nurses who helped save his life
yellow measurement yellow twirled around blue colored money signs and RX bottles and pills and shots
Health Lab
The heart of the question: Who can get Medicare-covered weight loss medicine?
Wegovy (semaglutide) now has Medicare approval for coverage among people with obesity and cardiovascular disease but no diabetes; a study looks at what level of risk might make someone eligible.