Telemedically Assisted Optimization for Heart Failure Patients Before Cardiac Surgery to Improve Perioperative Outcome

Summary

Patients with heart failure undergoing cardiac surgery face a significantly increased perioperative risk, yet no standardized strategy exists to mitigate this risk effectively. Current preoperative management relies on optimization of medical therapy without a structured prehabilitation approach. Given the strong association between eleveated preoperative N-terminal pro-B-type natriuretic peptide levels and postoperative outcomes, patients at increased risk could be identified using this biomarker. Telemedical disease management programs have demonstrated efficacy in outpatient heart failure care, but their role in preoperative optimization remains underexplored. This study aims to assess whether a structured, multidisciplinary, telemedicine-assisted prehabilitation program can reduce perioperative complications, and improve surgical outcomes.

Eligibility

Inclusion Criteria:

* Indication for elective cardiac surgery in the Heart team
* NTproBNP ≥ 1500 ng/L
* ≥ 18 years willing to participate in trial
* Written informed consent

Exclusion Criteria:

* Neuropsychiatric disorders / illnesses (e.g. drug addiction, alcohol abuse) that do not allow adherent participation in the study
* No sufficient ability to measure and transfer data or existing support in the social environment
* no sufficient ability to communicate (language skills, eyesight, hearing)
* Pregnancy
* Chronic kidney disease requiring dialysis
* Planed procedure: heart transplantation (HTX), implant of left ventricular mechanical assist devices (L-VAD)

Conditions2

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