Heart valve disease accounts for one‐third of all heart diseases and the prevalence is increasing due to an ageing population, population growth and advances in treatment methods.1 Heart valve diseases are mostly degenerative in nature and treatment of advanced heart valve disease includes surgery, either percutaneous or surgical valve replacement or repair. The changing disease pattern and expected increase in healthcare burden, and the large number of acute hospitalisations after valve surgery require a well‐established after‐care including cardiac rehabilitation. Issues after valve surgery also include physical and psychological issues. Physical inactivity is a problem for heart valve surgery patients, who may experience presurgical dyspnoea and physical incapacity, immobilisation during hospitalisation, and potential postsurgical complications and restrictions due to healing of the sternum. Open heart surgery is a stressful life event and health-related quality of life (HRQoL) is likely to be negatively affected, along with mental health; patients may require support for depressive symptoms and anxiety. Although such problems may also occur after percutaneous procedures, recent studies suggest that after transcatheter aortic valve replacement (TAVR), patients have much better HRQoL within 2 weeks of the procedure. Several attempts have been investigated to emphasise these issues and both European Society of Cardiology/European Association for Cardio‐Thoracic Surgery (ESC/EACTS) guidelines suggest cardiac rehabilitation after heart valve surgery.2 3 One trial has shown that individualised follow‐up programmes reduce readmissions after heart valve surgery. A meta‐analysis published in 2017 including six trials showed that participation in exercise training after TAVR can increase exercise capacity within the first year after the procedure.4 This is supported by a systematic review and meta‐analysis published in 2019 reporting that exercise‐based cardiac rehabilitation (CR) improves exercise capacity of post‐TAVR and post‐surgical aortic valve replacement (SAVR) patients in the short term.5 Current European guidelines recommend that rehabilitation after heart …

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Cochrane 角：成人心脏瓣膜手术后基于运动的心脏康复

心脏瓣膜病占所有心脏病的三分之一，并且由于人口老龄化、人口增长和治疗方法的进步，患病率正在增加。1 心脏瓣膜病本质上是退行性的，晚期心脏瓣膜病的治疗包括手术，或者经皮或手术瓣膜置换或修复。不断变化的疾病模式和医疗保健负担的预期增加，以及瓣膜手术后的大量急性住院需要完善的后期护理，包括心脏康复。瓣膜手术后的问题还包括生理和心理问题。缺乏身体活动是心脏瓣膜手术患者的一个问题，他们可能会出现术前呼吸困难和身体无力、住院期间无法活动、由于胸骨愈合而导致的潜在术后并发症和限制。心脏直视手术是一种压力很大的生活事件，与健康相关的生活质量 (HRQoL) 以及心理健康可能会受到负面影响；患者可能需要对抑郁症状和焦虑的支持。尽管经皮手术后也可能出现此类问题，但最近的研究表明，经导管主动脉瓣置换术 (TAVR) 后，患者在手术后 2 周内的 HRQoL 好得多。已经研究了几种强调这些问题的尝试，欧洲心脏病学会 / 欧洲心胸外科协会 (ESC / EACTS) 指南均建议心脏瓣膜手术后的心脏康复。2 3 一项试验表明，个体化的随访计划可减少心脏瓣膜手术后的再入院率。2017 年发表的一项包含六项试验的荟萃分析表明，在 TAVR 后参加运动训练可以在手术后的第一年内提高运动能力。4 这得到了 2019 年发表的系统评价和荟萃分析的支持，该分析报告说，基于运动的心脏康复 (CR) 可在短期内提高 TAVR 后和手术后主动脉瓣置换术 (SAVR) 患者的运动能力。5 当前欧洲指南建议心脏康复后……