Work

Novel Multidisciplinary Cardiometabolic Prehabilitation for Inoperable Aortic Aneurysm Management

Year: 2025

Type: article

Abstract: BACKGROUND: Health optimization before surgery is a key strategy to reduce perioperative complications and improve outcomes. However, patients with severe cardiometabolic disease and poor functional status present unique challenges. CASE SUMMARY: A 59-year-old man with a 6.7-cm ascending aortic aneurysm was deemed ineligible for surgery at 2 tertiary centers and 1 quaternary center because of severe obesity, poor functional status, and multiple comorbidities. He enrolled in Advanced Cardiac Energetics (ACE), a structured, multidisciplinary virtual program incorporating lifestyle changes, intermittent fasting, and mindfulness. Over 7 months, his weight, blood pressure, and functional capacity improved, and he successfully underwent aneurysm repair. DISCUSSION: Although prehabilitation is supported in the literature, strategies for obese, deconditioned patients are limited. This case demonstrates how Advanced Cardiac Energetics may expand surgical eligibility in high-risk populations and serve as a model for comprehensive preoperative care. TAKE-HOME MESSAGE: Multidisciplinary cardiometabolic care programs can deliver prehabilitation to enable life-saving cardiothoracic surgery for patients who are otherwise inoperable.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2025.104116