Minimally invasive heart valve surgery can benefit from optimized perioperative care. The INCREASE trial, presented at the European Society of Cardiology Conference 2025, evaluated whether an Enhanced Recovery After Surgery (ERAS) protocol could reduce hospital stay and maintain physical performance compared with standard care.

The INCREASE trial enrolled 201 adults scheduled for minimally invasive valve surgery. Participants were assigned to either an ERAS protocol, including prehabilitation, early extubation, and accelerated postoperative physiotherapy, or standard care. The modified intention-to-treat population included 190 patients (93 ERAS, 97 control).

Within one year after surgery, the ERAS group spent an average of 9.0 days in hospital due to cardiac causes, compared to 11.7 days in the control group. Adjusted analyses favored ERAS with a 29% reduction in hospital stay (p<0.01).

Physical performance at discharge, assessed by the six-minute walk test, was similar between groups. After disregarding baseline differences, the ERAS group reached non-inferiority compared with standard care.
These results demonstrate that ERAS protocols are feasible and safe in minimally invasive heart valve surgery. Patients can achieve earlier discharge while maintaining functional recovery, suggesting that interprofessional, accelerated perioperative care enhances post-surgical outcomes.