Characteristics of cardiac rehabilitation progress during hospitalization and in-hospital outcomes after mitral transcatheter edge-to-edge repair.

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Mitral regurgitation is a prevalent cardiac valvular disease, and its incidence is increasing with the aging population. While surgical intervention has traditionally been the standard treatment for this disease, in Japan, mitral transcatheter edge-to-edge repair (M-TEER) has emerged as a less invasive alternative since 2018. M-TEER demonstrates promising outcomes in reducing postoperative complications and shortening hospital stays. However, scarce data on cardiac rehabilitation (CR) following M-TEER is available. Therefore, in this study, we aimed to investigate the characteristics of CR progress during hospitalization and in-hospital outcomes following M-TEER. This single-center, retrospective cohort study involved 244 patients who underwent M-TEER at the Sakakibara Heart Institute between April 2018 and March 2023. Data on progress in CR and in-hospital outcomes, including hospitalization-associated disability (HAD), rate of return to home, and hospitalization that extended beyond 30days after M-TEER, were collected. After excluding patients who met the exclusion criteria-including conversion to surgical mitral valve replacement or the absence of CR during hospitalization-233 patients were included in the analysis. The patients' median age was 81years, with 48.5% being female. In 43% of cases, the hospitalizations were unplanned. Ambulation was initiated at a median of 1day after M-TEER, with 88.4% of patients being able to commence ambulation as early as 2days after M-TEER. However, only 19.3% engaged in aerobic exercise using equipment in the CR room. The median length of stay following M-TEER was 6days, with 4.7% of hospitalizations resulting in a stay of 30days or more. Ultimately, 90.6% of patients were discharged home, with an incidence of HAD of 9.9%. Compared to the planned hospitalization group, the unplanned hospitalization group had a significantly lower rate of early postoperative ambulation (planned hospitalization group: 97.7% vs. unplanned hospitalization group: 76.2%, p < 0.01), a higher proportion of patients with hospital stays exceeding 30days (0% vs. 10.9%, p < 0.01), a lower rate of home discharge (98.5% vs. 80.2%, p < 0.01), and an increased incidence of HAD (0.8% vs. 22.2%, p < 0.01). M-TEER provides a minimally invasive treatment option for mitral regurgitation with favorable early rehabilitation and in-hospital outcomes, particularly in planned hospitalization. However, for unplanned hospitalizations, inpatient outcomes were poor.