Prehabilitation in Cardiac Surgery: Part 2: Building a Prehab Loop and Delivering Individualized Multimodal Prehabilitation.

Cardiac prehabilitation can be structured as a continuous "Prehab Loop" integrating risk stratification, tailored multimodal interventions, reassessment, and timely surgery. This approach aligns with Enhanced Recovery After Surgery cardiac principles and supports individualized optimization through exercise, nutrition, inspiratory muscle training, and psychological support. Flexible delivery models-including outpatient, home-based, and digital pathways-improve accessibility while maintaining quality. Successful implementation depends on multidisciplinary coordination and system-level solutions to logistical and financial barriers. Addressing these factors enables pragmatic integration of prehabilitation into routine cardiac surgical care and supports ongoing program refinement.