The STS National Database has recognized that the procedure for coding Operative Re-Interventions that follows a principle cardiac surgical procedure is indeterminate. It is unclear among Data Managers whether or not to produce a new or second record for each intervention and as a result there is inconsistent data abstraction between STS National Database sites.

The STS and DCRI receive questions on a regular basis about how to manage collection of re-operative procedures. This was a topic of interest at the August Database manager’s meeting and at that time, an interim solution was made. That interim solution was to advise sites to continue to code the operative re-interventions as was done prior to the meeting. The STS Database Subcommittee would then make a definitive decision and communicate this to all STS National Database participant sites. To preserve the goal of the STS National Database by providing clinical information for principle cardiac procedures, the following is the final recommendation of the STS Database Subcommittee.

• Only one record is generated per surgical admission. Any second surgery that occurs within the primary surgical admission is treated as a complication of the first procedure. For example a Re-Operation for Bleeding or a Re-Operation for Valve Dysfunction after a CABG as the primary surgery should be recorded as such in the complication section of the primary procedure. No new record will be created.

• If STS National Database participant sites have a solid interest in tracking second surgical procedures in the same admission as the primary surgical procedure, (i.e., CABG is the primary and a Valve is done as the second procedure), then each site will be encouraged to track that data separately. These second surgical procedures would not be included in the data submitted to the DCRI Warehouse and Analysis Center. This recommendation will allow sites to have all the data necessary to fulfill other administrative requirements.