Commentary: A Puzzle With Many “Moving” Parts

      Postoperative cardiorespiratory fitness improves after proximal thoracic aortic aneurysm repair but not after acute Type A aortic dissection repair; the explanation is multifaceted.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Seminars in Thoracic and Cardiovascular Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Hillis L.D.
        • Smith P.K.
        • Anderson J.L.
        • et al.
        2011 ACCF/AHA guideline for coronary artery bypass graft surgery.
        Circulation. 2011; 124: e652-e735
        • Neumann F.-J.
        • Sousa-Uva M.
        • Ahlsson A.
        • et al.
        2018 ESC/EACTS guidelines on myocardial revascularization.
        Eur Heart J. 2019; 40: 87-165
        • Karkhanis R.
        • Wijeysundera H.C.
        • Tam D.Y.
        • et al.
        Cardiac rehabilitation is associated with improved long-term outcomes after coronary artery bypass grafting.
        CJC Open. 2021; 3: 167-175
        • Hiratzka L.F.
        • Bakris G.L.
        • Beckman J.A.
        • et al.
        2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with thoracic aortic disease.
        Circulation. 2010; 121: e266-e369
        • Erbel R.
        • Aboyans V.
        • Boileau C.
        • et al.
        2014 ESC guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC).
        Eur Heart J. 2014; 35: 2873-2926
        • Boodhwani M.
        • Andelfinger G.
        • Leipsic J.
        • et al.
        Canadian Cardiovascular Society position statement on the management of thoracic aortic disease.
        Can J Cardiol. 2014; 30: 577-589
        • Corone S.
        • Iliou M.C.
        • Pierre B.
        • et al.
        French registry 456 of cases of type I acute aortic dissection admitted to a cardiac rehabilitation center after 457 surgery.
        Eur J Cardiovasc Prev Rehabil. 2009; 16: 91-95
        • Chaddha A.
        • Kline-Rogers E.
        • Woznicki E.M.
        • et al.
        Activity recommendations for postaortic dissection patients.
        Circulation. 2014; 130: e140-e142
        • Norton E.L.
        • Wu K.-H.H.
        • Rubenfire M.
        • et al.
        Cardiorespiratory fitness after open repair for acute type A aortic dissection—A prospective study.
        Semin Thorac Cardiovasc Surg. 2022; 34: 827-839
        • Delsart P.
        • Maldonado-Kauffmann P.
        • Bic M.
        • et al.
        Post aortic dissection: Gap between activity recommendation and real life patients aerobic capacities.
        Int J Cardiol. 2016; 219: 271-276
        • Delsart P.
        • Delahaye C.
        • Devos P.
        • et al.
        Prognostic value of aerobic capacity and exercise oxygen pulse in postaortic dissection patients.
        Clin Cardiol. 2021; 44: 252-260
        • Fuglsang S.
        • Heiberg J.
        • Hjortdal V.E.
        • et al.
        Exercise-375 based cardiac rehabilitation in 376 surgically treated type-A aortic dissection patients.
        Scand Cardiovasc J. 2017; 51: 99-105
        • Kargarfard M.
        • Rouzbehani R.
        • Basati F.
        Effects of exercise rehabilitation on blood pressure of patients after myocardial infarction.
        Int J Prev Med. 2010; 1: 124-130
        • Badrov M.B.
        • Wood K.N.
        • Lalande S.
        • et al.
        Effects of 6 months of exercise-based cardiac rehabilitation on autonomic function and neuro-cardiovascular stress reactivity in coronary artery disease patients.
        J Am Heart Assoc. 2019; 8e012257
        • Cesari F.
        • Marcucci R.
        • Gori A.M.
        • et al.
        Impact of a cardiac rehabilitation program and inflammatory state on endothelial progenitor cells in acute coronary syndrome patients.
        Int J Cardiol. 2013; 167: 1854-1859
        • Paul J.D.
        • Powell T.M.
        • Thompson M.
        • et al.
        Endothelial progenitor cell mobilization and increased intravascular nitric oxide in patients undergoing cardiac rehabilitation.
        J Cardiopulm Rehabil Prev. 2007; 27: 65-73

      Linked Article

      • Cardiorespiratory Fitness After Open Repair for Acute Type A Aortic Dissection – A Prospective Study
        Seminars in Thoracic and Cardiovascular SurgeryVol. 34Issue 3
        • Preview
          Cardiorespiratory fitness (as measured by peak oxygen consumption [VO2peak]) is an independent predictor of cardiovascular disease and all-cause mortality. Limited data exist on VO2peak following repair for an acute type A aortic dissection (ATAAD) or proximal thoracic aortic aneurysm (pTAA). This study prospectively evaluated VO2peak, functional capacity, and health-related quality of life (HR-QOL) following open repair. Participants with a history of an ATAAD (n = 21) or pTAA (n = 43) performed cardiopulmonary exercise testing (CPX), 6-minute walk testing, and HR-QOL at 3 (early) and 15 (late) months following open repair.
        • Full-Text
        • PDF