Cardiac Rehabilitation After TAVI: From Procedural Success to Multidomain Recovery

Transcatheter aortic valve implantation (TAVI) relieves valvular obstruction, but recovery of mobility, independence, exercise capacity, and health-related quality of life remains incomplete in many patients. This narrative review critically appraises cardiac rehabilitation (CR) after TAVI and proposes a needs-guided recovery framework. A search of MEDLINE, trial registries, guidelines, and citation networks through 4 September 2026 identified small, heterogeneous randomised trials and observational and implementation studies. Exercise-based interventions provide the most consistent, although imprecise, signal for increased peak oxygen uptake; effects on walking capacity, lower-extremity performance, disability, and quality of life are variable. No randomised trial has demonstrated reduced rehospitalisation or mortality, and favourable cohort associations remain susceptible to referral, survival, and healthy-participant bias. Contemporary guidelines support comprehensive CR but do not define a universal initiation time, exercise dose, or TAVI-specific safety thresholds. We propose proactive referral, confirmation of medical readiness, and assessment of cardiovascular stability, physical performance, frailty, nutrition, cognition, mood, falls risk, and contextual barriers to guide individualised exercise, nutritional, behavioural, and self-management interventions. Delivery, supervision, progression, and maintenance should match risk and access. Pragmatic trials should establish durability, safety, disability-free survival, healthcare utilisation, equity, and cost-effectiveness.