The establishment of The Interagency Registry for Mechanically Assisted Circulatory Support (Intermacs) in 2005 was an important step forward for the community of medical providers who are involved in the field of mechanical circulatory support (MCS). For the first time, a large database was established to serve as a repository for all variables affecting patients receiving MCS. The mandate by the regulatory agencies (notably the Joint Commission) to require all programs performing device implantation to benchmark against Intermacs had the added benefit of incentivizing programs in the United States to make substantial internal investments to collect, track, and report their data accurately. On January 1, 2018, oversight and coordination of Intermacs moved to The Society of Thoracic Surgeons (STS) National Database. The incorporation of this database into the larger STS Council on Quality, Research, and Patient Safety will provide additional resources for detailed data collection, analysis, and scientific inquiry similar to the quality work that has emerged from the larger STS databases in cardiac, thoracic, and congenital surgery. In this issue of The Annals of Thoracic Surgery, Kormos and colleagues [1Kormos R.L. Cowger J. Pagani F.D. et al.The Society of Thoracic Surgeons Intermacs Database Annual Report: evolving indications, outcomes, and scientific partnerships.Ann Thorac Surg. 2019; 107: 341-354Abstract Full Text Full Text PDF PubMed Scopus (140) Google Scholar] have produced the annual report on the data from Intermacs. This report primarily focuses on documenting the outcomes of patients undergoing durable left ventricular assist device with the use of Food and Drug Administration-approved, continuous flow rotary pumps. One of the more interesting data points is the documentation of the shift from axial flow pumps to centrifugal flow pumps. This transition likely represents the natural history of pump implant choices that follow advances in technology with each new generation of devices. This report also continues to highlight the limitations of the current device technology; namely neurologic events, gastrointestinal bleeding, and infections. These remain the areas in need of the greatest improvement for caring for these patients and provide the benchmark by which each individual program should use in evaluating their outcomes. In addition, note that these data have traditionally been published in the Journal of Heart and Lung Transplantation that has a more generalized readership among transplant cardiologists, nursing professionals, pharmacists, and other disciplines. Thus, it is critical that we ensure that the publication of this data be widely accessible to the other members of the heart failure community and not restricted to the STS membership with a paid subscription. Similarly, with new leadership will come the daunting task of ensuring that these safeguarded data are easily accessible to other members in the discipline of MCS for research and analysis. With the STS now behind the database, we expect further scientific inquiries and scrutinized analyzes will continue to improve the outcomes for patients with end-stage heart failure for years to come. The Society of Thoracic Surgeons Intermacs Database Annual Report: Evolving Indications, Outcomes, and Scientific PartnershipsThe Annals of Thoracic SurgeryVol. 107Issue 2PreviewThe Interagency Registry for Mechanically Assisted Circulatory Support (Intermacs), a joint effort among the National Heart, Lung, and Blood Institute, the Food and Drug Administration, the Centers for Medicare and Medicaid Services, and others, was established in 2005 at the University of Alabama at Birmingham. The registry examined clinical outcomes and quality-of-life metrics of patients who received an Food and Drug Administration-approved durable mechanical circulatory support (MCS) device to treat advanced heart failure. Full-Text PDF
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