The Society of Thoracic Surgeons Intermacs 2020 Annual Report

The Society of Thoracic Surgeons (STS)-Interagency Registry for Mechanically Assisted Circulatory Support (Intermacs) 2020 Annual Report reviews outcomes on 25,551 patients undergoing primary isolated continuous-flow left ventricular assist device (LVAD) implantation between 2010 and 2019. In 2019, 3198 primary LVADs were implanted, which is the highest annual volume in Intermacs history. Compared with the previous era (2010-2014), patients who received an LVAD in the most recent era (2015-2019) were more likely to be African American (26.8% vs 22.9%, P < .0001) and more likely to be bridged to durable LVAD with temporary mechanical support devices (36.8% vs 26.0%, P < .0001). In 2019, 50% of patients were INTERMACS Profile 1 or 2 before durable LVAD, and 73% received an LVAD as destination therapy. Magnetic levitation technology has become the predominant design, accounting for 77% of devices in 2019. The 1- and 2-year survival in the most recent era has improved compared with 2010 to 2014 (82.3% and 73.1% vs 80.5% and 69.1%, respectively; P < .0001). Major bleeding and infection continue to be the leading adverse events. Incident stroke has declined in the current era to 12.7% at 1 year. STS-Intermacs research publications are highlighted, and the new quality initiatives are introduced. Department of Cardiac Surgery, MedStar Heart & Vascular Institute, Georgetown University, Washington, DC; Department of Heart Failure and Transplantation, Inova Heart and Vascular Institute, Falls Church, Virginia; Cardiovascular Center, Division of Cardiology, Tufts Medical Center, Boston, Massachusetts; Department of Medicine-Cardiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado; Division of Cardiothoracic and Vascular Surgery, Lutheran Hospital Indiana University School of Medicine - Fort Wayne, Fort Wayne, Indiana; Division of Cardiothoracic Surgery, Department of Surgery, Columbia University, New York, New York; Division of Cardiothoracic Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, Georgia; Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, West Virginia; STS Research Center, The Society of Thoracic Surgeons, Chicago, Illinois; Division of Thoracic and Cardiovascular Surgery, Department of Surgery, University of Florida, Gainesville, Florida; Kirklin Institute for Research in Surgical Outcomes, Birmingham, Alabama; Division of Cardiothoracic Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama; Department of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan; and Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, Michigan The Society of Thoracic Surgeons (STS)-Interagency Registry for Mechanically Assisted Circulatory Support (Intermacs) 2020 Annual Report reviews outcomes on 25,551 patients undergoing primary isolated continuous-flow left ventricular assist device (LVAD) implantation between 2010 and 2019. In 2019, 3198 primary LVADs were implanted, which is the highest annual volume in Intermacs history. Compared with the previous era (2010-2014), patients who received an LVAD in the most recent era (2015-2019) were more likely to be African American (26.8% vs 22.9%, P < .0001) and more likely to be bridged to durable LVAD with temporary mechanical support devices (36.8% vs 26.0%, P < .0001). In 2019, 50% of patients were INTERMACS Profile 1 or 2 before durable LVAD, and 73% received an LVAD as destination therapy. Magnetic levitation technology has become the predominant design, accounting for 77% of devices in 2019. The 1-and 2-year survival in the most recent era has improved compared with 2010 to 2014 (82.3% and 73.1% vs 80.5% and 69.1%, respectively; P < .0001). Major bleeding and infection continue to be the leading adverse events. Incident stroke has declined in the current era to 12.7% at 1 year. STS-Intermacs research publications are highlighted, and the new quality initiatives are introduced. (Ann Thorac Surg 2021;111:778-92) ? 2021 by The Society of Thoracic Surgeons

Automated summary

The STS-Intermacs 2020 Annual Report analyzed data from 25,551 patients who underwent LVAD implantation between 2010 and 2019, revealing an increase in African American patients and a higher proportion bridged to durable LVAD with temporary mechanical support devices. The report also showed improvements in 1- and 2-year survival rates in the most recent era compared to the previous era, with major bleeding and infection remaining as leading adverse events.