Particularities of cardiovascular rehabilitation after coronary artery bypass graft: a case report

Abstract

Objectives. This paper assesses the importance and contribution of cardiovascular rehabilitation programs in the short- and long-term outcome following surgical revascularization procedures for patients with coronary artery disease (CAD). Methods. We present the case of a 64-year-old patient who benefited from a coronary artery bypass graft (CABG) procedure for CAD, followed by an individualized cardiac rehabilitation program. The case particularity consisted of the presence of associated peripheral vascular disease that imposed additional challenge in decision-making process regarding surgical therapy. Results and discussion. Immediately after surgery, the patient was included in a phase II residential recovery program, preceded by a ramp effort test. The rehabilitation program consisted of partial toning massage of the lumbosacral spine, and individual physiotherapy. Coronary revascularization procedures often cause lowered exercise capacity and declining physical activity levels. In our case even preoperative assessment showed a limited physical effort capacity, further reduced by the surgical intervention. The physiotherapy plan should be personalized, safe, effective, and must increase the independent mobility of patient soon after open heart surgery. Conclusions. The main contribution of cardiac rehabilitation program should be the improvement of physical and social status of patients undergoing surgical myocardial revascularization. This program should be included in the management of all cardiac heart disease patients who benefit from cardiac surgery procedures. Implementation of CR programs at most hospitals and community centres, as well as awareness about their efficacy, would result in higher participation after coronary revascularization interventions and improvement of functional parameters and quality of life.