title: Cardiac rehabilitation and mid-term follow-up after transcatheter aortic valve implantation.
abstract: BACKGROUND
  Evaluation of patient outcomes following transcatheter aortic valve implantation (TAVI) has usually been based on survival and clinical improvement. Studies on quality of life are limited, and data from comprehensive assessments after the procedure are lacking.
  
  
  METHODS
  Sixty patients referred for cardiac rehabilitation after TAVI underwent in-hospital and after-discharge multidimensional assessments to evaluate clinical, functional, and nutritional statuses, degree of autonomy, cognitive impairment, depression and quality of life.
  
  
  RESULTS
  On admission to rehabilitation, approximately half of the patients had severe functional impairment and dependence for basic activities of daily living. During their hospital stay, one-third of the patients suffered significant clinical complications and two had to be transferred to the implantation center. Despite this, the overall outcome was very good. All of the remaining patients were clinically stable at discharge and functional status, autonomy and quality of life were improved in most. During a mean follow-up of 540 days (range: 192-738 days), five patients died from noncardiac causes, three were hospitalized for cardiac events, and nine for non cardiac reasons. Functional status and autonomy remained satisfactory in the majority of patients and most continued to live independently.
  
  
  CONCLUSIONS
  Patients referred for rehabilitation after TAVI are often very frail, with a high grade of functional impairment, dependence on others and high risk of clinical complications. During a rehabilitation programme, based on a multidimensional assessment and intervention, most patients showed significant improvement in functional status, quality of life, and autonomy, which remained stable in the majority of subjects during mid-term follow-up.
authors.affiliation: Cardiac Rehabilitation Centre, Istituti Clinici di Perfezionamento Hospital, via Bignami 1, 20126 Milan, Italy.
authors.forename: Renzo
authors.initials: R
authors.lastname: Zanettini
authors.affiliation: Cardiac Rehabilitation Centre, Istituti Clinici di Perfezionamento Hospital, via Bignami 1, 20126 Milan, Italy.
authors.forename: Gemma
authors.initials: G
authors.lastname: Gatto
authors.affiliation: Cardiac Rehabilitation Centre, Istituti Clinici di Perfezionamento Hospital, via Bignami 1, 20126 Milan, Italy.
authors.forename: Ileana
authors.initials: I
authors.lastname: Mori
authors.affiliation: Cardiac Rehabilitation Centre, Istituti Clinici di Perfezionamento Hospital, via Bignami 1, 20126 Milan, Italy.
authors.forename: Maria Beatrice
authors.initials: MB
authors.lastname: Pozzoni
authors.affiliation: De Gasperis Cardiology and Cardiac Surgery Department, Niguarda Ca' Granda Hospital, Piazza Ospedale Maggiore 3, 20162 Milan, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Pelenghi
authors.affiliation: De Gasperis Cardiology and Cardiac Surgery Department, Niguarda Ca' Granda Hospital, Piazza Ospedale Maggiore 3, 20162 Milan, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Martinelli
authors.affiliation: De Gasperis Cardiology and Cardiac Surgery Department, Niguarda Ca' Granda Hospital, Piazza Ospedale Maggiore 3, 20162 Milan, Italy.
authors.forename: Silvio
authors.initials: S
authors.lastname: Klugmann
keywords: Cardiac rehabilitation; Comprehensive assessment; Follow-up; Transcatheter aortic valve implantation