ABSTRACT
Introduction Successes in surgery, improvements in perioperative management and economical constraints have led to a marked abbreviation of in-hospital care of patients after valve surgery within recent years. Yet, on the other hand, more elderly and multimorbid patients are undergoing valve surgery, increasing the requirements for intensive medical management during the first weeks after heart valve surgery. Therefore, the postoperative management of these patients has become an integral part of cardiac rehabilitation in some European countries, such as in Switzerland, Austria, Hungary, Poland, France and Germany, where it is mostly practised as institutional rehabilitation. In Germany, this was instituted by law, and the cost of rehabilitating these patients is borne by the retirement funds of those still working and the sickness funds of those who have retired, with 80% of patients participating in rehabilitation after surgery. In Scandinavian countries, rehabilitation has mostly been performed on an outpatient basis. In other European countries, there are wide variations in the resources currently available for and the present provision of rehabilitation facilities.1
