Issue 25-2, 2026

Review

https://doi.org/10.38025/2078-1962-2026-25-2-53-62

Effectiveness of Respiratory Rehabilitation in Preventing Pulmonary Complications in Patients after Left Ventricular Geometric Reconstruction: A Prospective Study

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ORCIDMark A. Zatenko*, ORCIDMaxim L. Mamalyga, ORCIDMikhail M. Alshibaya, ORCIDTamara G. Djitava, ORCIDGalina V. Lobacheva, ORCIDSergei A. Danilov

A.N. Bakulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russia


ABSTRACT

INTRODUCTION. Respiratory complications are the most common consequence of cardiac surgery involving cardiopulmonary bypass (CPB). Patients undergoing left ventricular geometric reconstruction (LVGR) constitute a high-risk group due to the prolonged duration of the surgical intervention and respiratory impairments associated with chronic heart failure.

AIM. The present study aims to investigate the effectiveness of positive expiratory pressure (PEP) training and standard breathing exercises (BE) in preventing respiratory complications in patients in the early postoperative period following LVGR surgery.

MATERIALS AND METHODS. This prospective study comprised 30 patients after LVGR, who were divided into two groups: Group I (n = 15) received a course of PEP-training, while Group II (n = 15) underwent a course of standard BE. The assessment was based on computed tomography (CT) scans, spirometry tests and 24-hour pulse oximetry data obtained before surgery, on the 2nd–3rd days after surgery and at discharge (days 10–12).

RESULTS.  On the 2nd postoperative day, atelectasis was detected in 100 % of patients in both groups. By the time of discharge, the proportion of patients with atelectasis in Group I decreased to 53.3 %, while in Group II it remained at 93.3 % (p = 0.035). The volume of atelectasis in the lower lobes in Group I decreased by 91.9 % on the right and 84.0 % on the left, which is statistically significantly higher than the results of Group II: 63.4 and 38.6 %, respectively (p < 0.05). Group I also showed a more pronounced recovery of spirometry and 24-hour pulse oximetry parameters compared to Group II (p < 0.05).

DISCUSSION. The high incidence of atelectasis after LVGR is due to a combination of intraoperative factors and pre-existing heart failure. Standard breathing exercises have limited effectiveness in the resolution of formed atelectasis. The use of PEP-training, by creating positive airway pressure, promotes effective alveolar recruitment, improvement of bronchial patency, and acceleration of functional lung recovery.

CONCLUSION.   The use of PEP-training is a more effective method of respiratory rehabilitation after LVGR compared to standard BE, promoting a faster resolution of atelectasis and recovery of lung function.


KEYWORDS: atelectasis, left ventricular geometric reconstruction, respiratory rehabilitation, positive expiratory pressure, cardiac surgery, postoperative complications

ДЛЯ ЦИТИРОВАНИЯ: Затенко М.А., Мамалыга М.Л., Алшибая М.М., Джитава Т.Г., Лобачева Г.В., Данилов С.А. Эффективность респираторной реабилитации в профилактике легочных осложнений у пациентов после геометриче-ской реконструкции левого желудочка: проспективное исследование.Вестник восстановительной медицины. 2026; 25(2):53–62. https://doi.org/10.38025/2078-1962-2026-25-2-53-62 [Zatenko M.A., Mamalyga M.L., Alshibaya M.M., Djitava T.G., Lobacheva G.V., Danilov S.A. Effectiveness of Respiratory Rehabilitation in Preventing Pulmonary Complications in Patients after Left Ventricular Geometric Reconstruction: A Prospective Study. Bulletin of Rehabilitation Medicine. 2026; 25(2):53–62. https://doi.org/10.38025/2078-1962-2026-25-2-53-62 (In Russ.).]

FOR CORRESPONDENCE:

Mark A. Zatenko, E-mail: mazatenko@bakulev.ru


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This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.