AKINCI, BUKET

Acute type A aortic dissection is a life-threatening condition requiring emergency surgery and complex postoperative management. Although survival rates have improved, many patients experience long-term functional impairments, reduced quality of life, and an elevated risk of complications. Despite strong evidence supporting cardiac rehabilitation in other cardiovascular populations, structured programs remain underutilized in patients with surgically resolved acute type A aortic dissection. Exercise-based cardiac rehabilitation appears feasible and can be delivered safely in carefully selected patients when appropriately adapted to individual needs and conducted under close supervision. Postoperative patients are often physically deconditioned, prone to hospital-acquired disability, and may misjudge exercise intensity. Therefore, individualized exercise prescription, guided by exercise testing when available, is important to support safe training thresholds. Early and gradual introduction of physical activity may help prevent complications associated with immobility, support blood pressure control, and contribute to improvements in functional capacity. However, training volume should be purposefully lower than in conventional program settings to reduce hemodynamic stress. Education on safe exercise parameters and self-monitoring plays a central role in enabling long-term adherence and promoting patient autonomy. Cardiac rehabilitation programs should incorporate dietary, nutritional, and psychological support. Although evidence specific to this patient population remains limited, available data suggest the feasibility and potential benefits of cardiac rehabilitation when delivered with appropriate precautions. Our review underscores the need for a tailored, multidisciplinary CR approach aimed at enhancing physical recovery, supporting cardiovascular stability, and improving overall quality of life in patients following surgery. Further research is required to define optimal program protocols.

Cardiac rehabilitation is strongly recommended in secondary cardiovascular prevention. In patients after coronary artery bypass grafting, this intervention is suggested to reduce mortality, morbidity, and disability. In addition, rehabilitation programs improve quality of life and cardiorespiratory fitness. Modern cardiac rehabilitation programs include structured exercise training, education, nutritional counseling, psychosocial support, and management of cardiovascular risk factors, each tailored to the specific needs of post-coronary artery bypass grafting patients who often face a high burden of comorbidities and surgical recovery challenges. For these reasons, cardiac rehabilitation should be regarded as standard of care. Evidence supports early cardiac rehabilitation initiation and individualized multidisciplinary plans, which have shown to improve exercise capacity, health-related quality of life, and medication adherence. Long-term follow-up is essential, as studies have demonstrated a clear association between sustained cardiac rehabilitation engagement and decreased rates of rehospitalization and all-cause mortality. Therefore, this comprehensive review presents recent advances and updates on the management of patients after coronary artery bypass grafting during cardiac rehabilitation, with a focus on the core components and long-term follow-up.