NCT02219815.

Trial name or title	Pre‐operative rehabilitation for reduction of hospitalization after coronary bypass and valvular surgery (PREHAB)
Methods	RCT
Participants	Inclusion Criteria: Patients aged 65 years and older, undergoing elective isolated CABG, aortic valve repair/replacement for moderate aortic stenosis or severe regurgitation, mitral valve repair/replacement for moderate stenosis or severe regurgitation or combined CABG/valve procedures. Patients with Clinical Frailty Score (CFS) ≥ 4 (vulnerable) and < 7 (8 = very severely frail, approaching end‐of‐life or 9 = terminally ill) at time of acceptance for cardiac surgery. Patients with an estimated ≥ 6 week wait time. Exclusion Criteria: Patients who have unstable or recent unstable cardiac syndrome as defined by: severe heart failure (NYHA IV) or angina (CCS class IV) symptoms; critical left main (LM) coronary disease; hospitalisation for arrhythmias, congestive heart failure or acute coronary syndrome prior to randomisation. Patients who have severe left ventricular obstructive disease as defined by: severe aortic or mitral stenosis (aortic or mitral valve area < 1.0 cm2 or mean gradient > 40 mmHg or > 10 mmHg respectively); dynamic left ventricular (LV) outflow obstruction. Patients who have demonstrated exercise‐induced ventricular arrhythmias or have experienced a recent hospitalisation for arrhythmias. Patients who have cognitive deficits that would preclude rehabilitation. Patients who have physical limitations that would preclude rehabilitation. Patients who are unable to attend the Prehab programme.
Interventions	Intervention: Patients will receive an eight‐week comprehensive exercise therapy and education programme at a community‐based CR facility. Comparator: standard care.
Outcomes	Mortality, major adverse cardiac events, HRQL.
Starting date	September 2014
Contact information	Dr. Rakesh C. Arora rarora@sbgh.mb.ca
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