The Society of Thoracic Surgeons Workforce on Evidence Based Surgery develops clinical practice documents including clinical practice guidelines, expert consensus documents, and expert opinion/white papers to provide practical assistance to the STS membership. These documents are intended to assist physicians and other health care providers in clinical decision-making by describing a range of generally acceptable approaches for the diagnosis, management, or prevention of specific diseases or conditions.
Clinical practice guideline documents are thoroughly reviewed, and the conclusions and recommendations are based on a systematic review of scientific evidence published in medical literature.
Expert consensus documents represent the collective opinions of an expert panel on a clinical topic. The opinions expressed in the statement(s) are not generally developed in accordance with the formal evidence review process outline for clinical practice guidelines. The authors may suggest treatment strategies based on their collective knowledge and clinical experience.
An expert opinion/white paper is authored by leading experts on clinical topics with scarce data and significant uncertainty. These documents are intended to synthesize existing scientific literature, divergent opinions, and other treatment strategies, rather than provide recommendations.
Adult Cardiac Surgery
Diagnosing and Treating Acute and Chronic Syndromes of the Aortic Organ (2024)
-
EACTS/STS Guidelines for Diagnosing and Treating Acute and Chronic Syndromes of the Aortic Organ
Martin Czerny, Martin Grabenwoger, Tim Berger, Victor Aboyans, Alessandro DellaCorte, Edward P. Chen, Nimesh D. Desai, Julia Dumfarth, John A. Elefteriades, Christian D. Etz, Karen M. Kim, Maximilian Kreibich, Mario Lescan, Luca Di Marco, Andreas Martens, Carlos A. Mestres, Milan Milojevic, Christoph A. Nienaber, Gabriele Piffaretti, Ourania Preventza, Eduard Quintana, Bartosz Rylski, Christopher L. Schlett, Florian Schoenhoff, Santi Trimarchi, and Konstantinos Tsagakis, EACTS/STS Scientific Document Group
© 2024 The Society of Thoracic Surgeons and the European Association for Cardio-Thoracic Surgery
Surgical Treatment of Atrial Fibrillation (2023)
- The Society of Thoracic Surgeons 2023 Clinical Practice Guidelines for the Surgical Treatment of Atrial Fibrillation
Moritz C. Wyler von Ballmoos, MD, PhD, Dawn S. Hui, MD, J. Hunter Mehaffey, MD, MSc, S. Chris Malaisrie, MD, Panos N. Vardas, MD, A. Marc Gillinov, MD, Thoralf M. Sundt, MD, Vinay Badhwar, MD
© 2023 The Society of Thoracic Surgeons
Prevention of Adult Cardiac Surgery–Associated Acute Kidney Injury (2023)
- The Society of Thoracic Surgeons/Society of Cardiovascular Anesthesiologists/American Society for Extracorporeal Technology Clinical Practice Guidelines for the Prevention of Adult Cardiac Surgery–Associated Acute Kidney Injury
Jeremiah R. Brown, PhD, MS, Robert A. Baker, PhD, CCP, Linda Shore-Lesserson, MD, Amanda A. Fox, MD, MPH, Linda B. Mongero, CCP, Kevin W. Lobdell, MD, Scott A. LeMaire, MD, Filip M. J. J. DeSomer, PhD, EBCP, Moritz Wyler von Ballmoos, MD, PhD, Viachaslau Barodka, MD, Rakesh C. Arora, MD, PhD, Scott Firestone, MS, Richard Solomon, MD, Chirag R. Parikh, MD, PhD, Kenneth G. Shann, CCP, and John Hammon, MD
© 2023 International Anesthesia Research Society
Type B Aortic Dissection (2021)
- The Society of Thoracic Surgeons/American Association for Thoracic Surgery Clinical Practice Guidelines on the Management of Type B Aortic Dissection
Thomas E. MacGillivray, MD, Thomas G. Gleason, MD, Himanshu J. Patel, MD, Gabriel S. Aldea, MD, Joseph E. Bavaria, MD, Thomas M. Beaver, MD, Edward P. Chen, MD, Martin Czerny, MD, Anthony L. Estrera, MD, Scott Firestone, MS, Michael P. Fischbein, MD, G. Chad Hughes, MD, Dawn S. Hui, MD, Kalie Kissoon, Jennifer S. Lawton, MD, Davide Pacini, MD, T. Brett Reece, MD, Eric E. Roselli, MD, and John Stulak, MD
© 2021 The Society of Thoracic Surgeons and the American Association for Thoracic Surgery
Patient Blood Management (2021)
- STS/SCA/AmSECT/SABM Update to the Clinical Practice Guidelines on Patient Blood Management
Pierre Tibi, MD, R. Scott McClure, MD, FRCSC, Jiapeng Huang, MD, Robert A. Baker, PhD, CCP, David Fitzgerald, DHA, CCP, C. David Mazer, MD, Marc Stone, MD, Danny Chu, MD, Alfred H. Stammers, MSA, CCP Emeritus, Tim Dickinson, CCP, Linda Shore-Lesserson, MD, Victor Ferraris, MD, Scott Firestone, MS, Kalie Kissoon, and Susan Moffatt-Bruce, MD, FRCSC
© 2021 The Society of Thoracic Surgeons, the American Society of ExtraCorporeal Technology, and Elsevier Inc.
Transesophageal Echocardiography (2020)
- Guidelines for the Use of Transesophageal Echocardiography to Assist with Surgical Decision-Making in the Operating Room: A Surgery-Based Approach From the American Society of Echocardiography in Collaboration with the Society of Cardiovascular Anesthesiologists and the Society of Thoracic Surgeons
Alina Nicoara, Chair, MD, FASE, Nikolaos Skubas, Co-Chair, MD, DSc, FASE, Niv Ad, MD, Alan Finley, MD, FASE, Rebecca T. Hahn, MD, FASE, Feroze Mahmood, MD, FASE, Sunil Mankad, MD, FASE, Charles B. Nyman, MBBCh, Francis Pagani, MD, PhD, Thomas R. Porter, MD, FASE, Kent Rehfeldt, MD, FASE, Marc Stone, MD, Bradley Taylor, MD, MPH, Annette Vegas, MD, FRCPC, FASE, Karen G. Zimmerman, BS, ACS, RDCS (AE, PE), RVT, FASE, William A. Zoghbi, MD, FASE, and Madhav Swaminathan, MD, FASE
© 2020 The American Society of Echocardiography
Anticoagulation During Cardiopulmonary Bypass (2018)
- The Society of Thoracic Surgeons, The Society of Cardiovascular Anesthesiologists, and The American Society of ExtraCorporeal Technology: Clinical Practice Guidelines—Anticoagulation During Cardiopulmonary Bypass
Linda Shore-Lesserson, MD, Robert A. Baker, PhD, CCP, Victor A. Ferraris, MD, PhD, Philip E. Greilich, MD, David Fitzgerald, MPH, CCP, Philip Roman, MD, MPH, and John W. Hammon, MD
© 2018 The Society of Thoracic Surgeons, the Society of Cardiovascular Anesthesiologists, and the American Society of ExtraCorporeal Technology
Arterial Conduits for Coronary Artery Bypass Grafting (2016)
- The Society of Thoracic Surgeons Clinical Practice Guidelines on Arterial Conduits for Coronary Artery Bypass Grafting
(Supplemental Materials) Gabriel S. Aldea, MD, Faisal G. Bakaeen, MD, Jay Pal, MD, PhD, Stephen Fremes, MD, Stuart J. Head, MD, PhD, Joseph Sabik, MD, Todd Rosengart, MD, A. Pieter Kappetein, MD, PhD, Vinod H. Thourani, MD, Scott Firestone, MS, and John D. Mitchell, MD
© 2016 The Society of Thoracic Surgeons
Perioperative Care in Cardiac Surgery (2023)
- Perioperative Care in Cardiac Surgery: A Joint Consensus Statement by the Enhanced Recovery After Surgery (ERAS) Cardiac Society, ERAS International Society, and The Society of Thoracic Surgeons (STS)
Michael C. Grant, MD, MSE, Cheryl Crisafi, MS, RN, Adrian Alvarez, MD, Rakesh C. Arora, MD, PhD, Mary E. Brindle, MD, MPH, Subhasis Chatterjee, MD, Joerg Ender, MD, Nick Fletcher, MBBS, Alexander J. Gregory, MD, Serdar Gunaydin, MD, PhD, Marjan Jahangiri, MBBS, MS, Olle Ljungqvist, MD, PhD, Kevin W. Lobdell, MD, Vicki Morton, DNP, V. Seenu Reddy, MD, MBA, Rawn Salenger, MD, Michael Sander, MD, Alexander Zarbock, MD, Daniel T. Engelman, MD
© 2023 The Authors. Published by Elsevier Inc. on behalf of the Society of Thoracic Surgeons.
Surgical Heart Valve Characteristics for Optimal Valve Prosthesis Selection (2021)
- Essential Information on Surgical Heart Valve Characteristics for Optimal Valve Prosthesis Selection: Expert Consensus Document From the European Association for Cardio-Thoracic Surgery (EACTS)–The Society of Thoracic Surgeons (STS)–American Association for Thoracic Surgery (AATS) Valve Labelling Task Force
Andras P. Durko, MD, Philippe Pibarot, DVM, PhD, Pavan Atluri, MD, Vinayak Bapat, MD, Duke E. Cameron, MD, Filip P. A. Casselman, MD, PhD, Edward P. Chen, MD, Gry Dahle, MD, John A. Elefteriades, MD, PhD, Patrizio Lancellotti, MD, PhD, Richard L. Prager, MD, Raphael Rosenhek, MD, Alan Speir, MD, Marco Stijnen, PhD, Giordano Tasca, MD, PhD, Ajit Yoganathan, PhD, Thomas Walther, MD, PhD, and Ruggero De Paulis, MD (Task Force Chairman); EACTS–STS–AATS Valve Labelling Task Force
© 2021 Jointly between the Society of Thoracic Surgeons, the American Association for Thoracic Surgery, and the European Association for Cardio-Thoracic Surgery Association for Cardio-Thoracic Surgery, and the Extracorporeal Life Support Organization
Stage Classification Expert Consensus Update: A Review and Incorporation of Validation Studies (2021)
- SCAI SHOCK Stage Classification Expert Consensus Update: A Review and Incorporation of Validation Studies
Srihari S. Naidu, MD, FSCAI, David A. Baran, MD, FSCAI, Jacob C. Jentzer, MD, Steven M. Hollenberg, MD, Sean van Diepen, MD, MSc, Mir B. Basir, DO, FSCAI, Cindy L. Grines, MD, MSCAI, Deborah B. Diercks, MD, MSc, FACEP, Shelley Hall, MD, Navin K. Kapur, MD, FSCAI, William Kent, MD, MSc, Sunil V. Rao, MD, FSCAI, Marc D. Samsky, MD, Holger Thiele, MD, FESC, Alexander G. Truesdell, MD, FSCAI, Timothy D. Henry, MD, MSCAI
© 2021 The Authors. Published by Elsevier Inc. on behalf of the Society for Cardiovascular Angiography and Interventions Foundation.
Post-Cardiotomy Extracorporeal Life Support in Adult Patients
- 2020 EACTS/ELSO/STS/AATS Expert Consensus on Post-Cardiotomy Extracorporeal Life Support in Adult Patients (2020)
Roberto Lorusso, MD, PhD, Glenn Whitman, MD, Milan Milojevic, MD, PhD, Giuseppe Raffa, MD, PhD, David M. McMullan, MD, Udo Boeken, MD, PhD, Jonathan Haft, MD, Christian A. Bermudez, MD, Ashish S. Shah, MD, and David A. D’Alessandro, MD
© 2021 Jointly between The Society of Thoracic Surgeons, the American Association for Thoracic Surgery, the European Association for Cardio-Thoracic Surgery, and the Extracorporeal Life Support Organization
Transcatheter Mitral Valve Intervention (2019)
- 2019 AATS/ACC/SCAI/STS Expert Consensus Systems of Care Document: Operator and Institutional Recommendations and Requirements for Transcatheter Mitral Valve Intervention: A Joint Report of the American Association for Thoracic Surgery, the American College of Cardiology, the Society for Cardiovascular Angiography and Interventions, and The Society of Thoracic Surgeons
Robert O. Bonow, MD, MS, Patrick T. O’Gara, MD, MACC, David H. Adams, MD, FACC, Vinay Badhwar, MD, FACC, Joseph E. Bavaria, MD, FACC, Sammy Elmariah, MD, MPH, Judy W. Hung, MD, FACC, JoAnn Lindenfeld, MD, FACC,k Alanna Morris, MD, MSc, Ruby Satpathy, MD, FACC, Brian Whisenant, MD, FACC, and Y. Joseph Woo, MD, FACC
© 2020 The Society of Thoracic Surgeons, the American Association for Thoracic Surgery, the American College of Cardiology Foundation, and the Society for Cardiovascular Angiography and Interventions
General Thoracic Surgery
Multimodality Therapy for Locally Advanced Cancer of the Esophagus or Gastroesophageal Junction (2023)
- The Society of Thoracic Surgeons/American Society for Radiation Oncology Updated Clinical Practice Guidelines on Multimodality Therapy for Locally Advanced Cancer of the Esophagus or Gastroesophageal Junction
Stephanie G. Worrell, MD, Karyn A. Goodman, MD, Nasser K. Altorki, MD, Jonathan B. Ashman, MD, Traves D. Crabtree, MD, Jennifer Dorth, MD, Scott Firestone, MS, David H. Harpole, MD, Wayne L. Hofstetter, MD, Theodore S. Hong, MD, Kalie Kissoon, BS, Geoffrey Y. Ku, MD, Daniela Molena, MD, Joel E. Tepper, MD, Thomas J. Watson, MD, Terence Williams, MD, PhD, and Christopher Willett, MD
© 2023 The Society of Thoracic Surgeons and the American Society for Radiation Oncology
Malignant Pleural Effusions (2018)
- Management of Malignant Pleural Effusions: An Official ATS/STS/STR Clinical Practice Guideline
David J. Feller-Kopman*, Chakravarthy B. Reddy*, Malcolm M. DeCamp, Rebecca L. Diekemper, Michael K. Gould, Travis Henry, Narayan P. Iyer, Y. C. Gary Lee, Sandra Z. Lewis, Nick A. Maskell, Najib M. Rahman, Daniel H. Sterman, Momen M. Wahidi, and Alex A. Balekian; on behalf of the American Thoracic Society, Society of Thoracic Surgeons, and Society of Thoracic Radiology
© 2018 The American Thoracic Society, The Society of Thoracic Surgeons, and The Society of Thoracic Radiology
Prophylaxis and Management of Atrial Fibrillation Associated With General Thoracic Surgery (2011)
- The Society of Thoracic Surgeons Practice Guideline on the Prophylaxis and Management of Atrial Fibrillation Associated With General Thoracic Surgery: Executive Summary
Hiran C. Fernando, MD, Michael T. Jaklitsch, MD, Garrett L. Walsh, MD, James E. Tisdale, PhD, Charles D. Bridges, MD, ScD, John D. Mitchell, MD, and Joseph B. Shrager, MD
© 2011 The Society of Thoracic Surgeons
Surgical Management of Thymoma (2024)
- STS Expert Consensus Document on the Surgical Management of Thymomas
Douglas Z Liou, MD, Mark F. Berry, MD, Lisa M. Brown, MD, Todd L. Demmy, MD, James Huang, MD, Onkar V. Khullar, MD, Sukhmani K. Padda, MD, Rachit D. Shah, MD, Matthew D. Taylor, MD, Seyfi Alper Toker, MD, Elisabeth Weiss, MD, Sean C. Wightman, MD, Stephanie G. Worrell, MD, J.W. Awori Hayanga, MD MPH
© 2024 The Society of Thoracic Surgeons
Management of Pleural Drains Following Pulmonary Lobectomy (2024)
- The Society of Thoracic Surgeons Expert Consensus Document on the Management of Pleural Drains following Pulmonary Lobectomy
Michael S. Kent, MD, Brian Mitzman, MD, MS, Ilitch Diaz-Gutierrez, MD, Onkar V. Khullar, MD, MSc, Hiran Fernando, MD, Leah Backhus, MD, MPH, Alessandro Brunelli, MD, Stephen D. Cassivi, MD, Robert J. Cerfolio, MD, MBA, Traves D. Crabtree, MD, Jahnavi Kakuturu, MD, Linda W. Martin, MD, MPH, Daniel P. Raymond, MD, Lana Schumacher, MD, J.W. Awori Hayanga, MD, MPH
© 2024 The Society of Thoracic Surgeons
Pulmonary Metastasectomy (2019)
- Expert Consensus Document on Pulmonary Metastasectomy (2019)
John R. Handy, MD, Ross M. Bremner, MD, Todd S. Crocenzi, MD, Frank C. Detterbeck, MD, Hiran C. Fernando, MD, Panos M. Fidias, MD, Scott Firestone, MS, Candice A. Johnstone, MD, Michael Lanuti, MD, Virginia R. Litle, MD, Kenneth A. Kesler, MD, John D. Mitchell, MD, Harvey I. Pass, MD, Helen J. Ross, MD, and Thomas K. Varghese, MD
© 2019 The Society of Thoracic Surgeons
Congenital Heart Surgery
Management with Coarctation (2024)
- STS Clinical Practice Guidelines on the Management of Neonates and Infants with Coarctation
Elizabeth H. Stephens, MD, Ph.D, Eric N. Feins, MD, Tara Karamlou, MD, Brett R. Anderson, MD, MBA, MS, Bahaaladin Alsoufi, MD, Mark S. Bleiweis, MD, Yves d’Udekem, MD, PhD, Jennifer S. Nelson, MD, MS, Awais Ashfaq, MD, Bradley S. Marino, MD, MPP, MSCE, MBA, James D. St. Louis, MD,k Hani K. Najm, MD, MSc,l Joseph W. Turek, MD, PhD, MBA, Danial Ahmad, MD, MPH, Joseph A. Dearani, MD, Jeffrey P. Jacobs, MD
© 2024 The Society of Thoracic Surgeons
Protecting the Infant Brain During Cardiac Surgery (2012)
- Protecting the Infant Brain During Cardiac Surgery: A Systematic Review for The Society of Thoracic Surgeons Evidence Based Medicine and Congenital Heart Surgery Task Forces
Jennifer C. Hirsch, MD, MS, Marshall L. Jacobs, MD, Dean Andropoulos, MD, Erle H. Austin, MD, Jeffrey P. Jacobs, MD, Daniel J. Licht, MD, Frank Pigula, MD, James S. Tweddell, MD, and J. William Gaynor, MD
© 2012 The Society of Thoracic Surgeons
Nomenclature and Classification of the Congenital Bicuspid Aortic Valve (2021)
- International Consensus Statement on Nomenclature and Classification of the Congenital Bicuspid Aortic Valve
Hector I. Michelena, MD, Alessandro Della Corte, MD, PhD, Arturo Evangelista, MD, Joseph J. Maleszewski, MD, William D. Edwards, MD, Mary J. Roman, MD, Richard B. Devereux, MD, Borja Fernandez, PhD, Federico M. Asch, MD, Alex J. Barker, PhD, Lilia M. Sierra-Galan, MD, Laurent De Kerchove, MD, Susan M. Fernandes, LPD, PA-C, Paul W. M. Fedak, MD, PhD, Evaldas Girdauskas, MD, Victoria Delgado, MD, Suhny Abbara, MD, Emmanuel Lansac, MD, Siddharth K. Prakash, MD, PhD, Malenka M. Bissell, MD, Bogdan A. Popescu, MD, PhD, Michael D. Hope, MD, Marta Sitges, MD, PhD, Vinod H. Thourani, MD, Phillippe Pibarot, DVM, PhD, Krishnaswamy Chandrasekaran, MD, Patrizio Lancellotti, MD, Michael A. Borger, MD, John K. Forrest, MD, John Webb, MD, Dianna M. Milewicz, MD, PhD, Raj Makkar, MD, Martin B. Leon, MD, Stephen P. Sanders, MD, Michael Markl, PhD, Victor A. Ferrari, MD, William C. Roberts, MD, Jae-Kwan Song, MD, PhD, Philipp Blanke, MD, Charles S. White, MD, Samuel Siu, MD, SM, Lars G. Svensson, MD, PhD, Alan C. Braverman, MD, Joseph Bavaria, MD, Thoralf M. Sundt, MD, Gebrine El Khoury, MD, Ruggero De Paulis, MD, Maurice Enriquez-Sarano, MD, Jeroen J. Bax, MD, Catherine M. Otto, MD, and Hans-Joachim Schäfers, MD
© 2021 Jointly between The Society of Thoracic Surgeons, The American Association for Thoracic Surgery, The European Association for Cardio-Thoracic Surgery, and The Radiological Society of North America. Published by Elsevier Inc.
STS-Endorsed Clinical Practice Documents
- ACC/AHA Guideline for the Management of Patients with Valvular Heart Disease (2020)
- Global Health Initiatives in Cardiothoracic Surgery: Ethical Considerations and Guidelines (2020)
- ACC/AHA/HRS Guideline on the Evaluation and Management of Patients with Bradycardia and Cardiac Conduction Delay (2018)
- AHA/ACC Guideline for the Management of Adults with Congenital Heart Disease (2018)
- AHA/ACC Guideline Focused Update of the 2014 AHA/ACC Guideline on the Management of Valvular Heart Disease (2017)
- ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients with Coronary Artery Disease (2016)
STS Guideline Policies
Clinical practice guidelines are intended as one element of the physician’s armamentarium and should not be considered inclusive of all proper methods of care or exclusive of other methods of care reasonably directed at obtaining the same results. Moreover, these guidelines are subject to change over time, without notice. The ultimate judgment regarding the care of a particular patient must be made by the physician in light of the individual circumstances presented by the patient.
STS clinical practice guidelines may be printed or downloaded for individual and personal use only. Guidelines may not be reproduced in any print or electronic publication or offered for sale or distribution in any format without the express written permission of The Society of Thoracic Surgeons.