Table 1 Details of the eligibility

Patients

- The population will consist of adults 18 years or older following (isolated or combined): aortic root replacement, Bentall/David/Yacoub/Lansac surgery, supracoronary ascending aortic replacement, (partial) aortic arch replacement, (frozen) elephant trunk surgery, or descending thoracic (or thoracoabdominal) aortic replacement

- Patients following both open surgery (i.e. sternotomy, thoracotomy, and thoracophrenolaparotomy) and minimally invasive procedures (i.e. hemi-sternotomy) will be included

- The population will not consist of adults following isolated aortic valve replacement, endovascular procedures, or conservative treatment

Intervention

- Phase III outpatient exercise-based cardiac rehabilitation

- Cardiac rehabilitation is defined as “exercise training and comprehensive services including education, psychological input, and safety recommendations focusing on health and lifestyle behaviour change, risk factor modification, and psychosocial wellbeing”[9]

Outcomes

- Performance-based outcomes (e.g. maximal oxygen uptake or maximum walking distance); patient-reported outcomes (e.g. quality of life, fatigue, pain, or perceived exertion); clinician-reported outcomes (e.g. blood pressure or heart rate), and researcher-reported outcomes (e.g. Serious) Adverse events and suspected unexpected serious adverse reactions)

Measurement instruments

- Performance-based measures (e.g. cardiopulmonary exercise test or 6-min walking test); patient-reported measures (e.g. RAND-36, SF-12, numerical rating scale or BORG scale); clinician-reported measures (e.g. blood pressure monitor or electrocardiography), and researcher-reported measures (e.g. study case report forms)

Study types

- Observational studies (e.g. cohort studies) and interventional studies (e.g. randomised controlled trials)

Meta-analysis

- Studies will be included in literature review when it is not clear whether the reported outcomes come only from the patients following thoracic aortic surgery, for example when data from patients following thoracic aortic surgery and cardiac surgery are pooled; however, these outcomes will not be included in the meta-analysis