[Medical rehabilitation of patients having undergone cardiovascular operations]

Among the measures of medical rehabilitation of patients who survived cardiovascular surgical procedures an important place belongs to the problems of physical readaptation. Its degree is determined by exercise tests, among which veloergometry has gained wide recognition. The methods of bicycle tests are discussed with reference to this category of patients. A study of the exercise tolerance and of the nature of the response conducted according to several cardiovascular functional indices in patients following closed mitral commissurotomy and surgical correction of non-cyanotic congenital heart diseases indicated that a certain discrepancy exists between the commonly accepted evaluation of the results of surgery and the degree of physical readaptation. The latter depends on several factors: the duration of the history of the disease, relapse of rheumatism, pulmonary hypertension, atrial fibrillation. In order to evaluate the effect of physical training on the degree of readaptation a comparative study is necessary between the rehabilitation group and a "control" group. In patients operated for symptomatic hypertension (renovascular, adrenal, coarctation of the aorta) the assessment of the results of surgery should not be limited by the determination of the decrease or normalization of the arterial pressure alone, but should be supplemented by a general clinical evaluation of the state of the patients. Rational hypotensive therapy significantly improves the results of surgery. The exercise tests permit to establish the functional reserves of the patients, to properly determine the tactics of their treatment and their occupational prognosis.