Aneurysm CaRe ­– Randomized Controlled Feasibility Trial of Cardiac Rehabilitation versus Standard Care After Aortic Aneurysm Repair

Background & Aims Abdominal and thoracic aortic aneurysms (A/TAA) are a major cause of mortality in older adults. Most deaths post-A/TAA repair result from cardiovascular events, which may be preventable with cardiac rehabilitation (CR) – a multidisciplinary approach to cardiovascular recovery. The feasibility and acceptability of CR in A/TAA patients remain unknown. Methods This 1:1, non-blinded feasibility randomised trial compared CR to standard care (SC) after elective A/TAA repair at two UK tertiary centres. Patients <50 years, diagnosed with connective tissue disorders, or deemed too unfit for CR were excluded at screening. The CR group followed an 8-week structured programme focusing on medical risk reduction, supervised exercise, and lifestyle modification. Co-primary outcomes were enrolment (target: 60.0%) and CR compliance (target: 70.0%). Secondary outcomes included major cardiac events, cardiovascular biomarkers, echocardiography, lifestyle, and quality of life metrics. This trial was supported by a British Heart Foundation Grant (PG/13/98/30490). Results From September 2014 – September 2015, 159 patients were screened, 97 were eligible, and 68 (70.1%) were randomised (SC: 34, CR: 34). CR adherence was 61.8% (n=21), with 13 withdrawals, primarily due to travel and personal commitments (69.2%). At 36 weeks, CR participants maintained higher physical activity levels (40 min vs. 30 min, p = 0.042). Conclusion Recruiting patients after A/TAA repair to CR is feasible, with good adherence. Virtual or video-based CR may help overcome barriers related to accessing CR. Trial registration ISRCTN (65746249).