Guide for Authors

  • Online manuscript submission website:

    For submissions prior to February 1, 2015:

    L. Henry Edmunds, Jr, MD
    Editor, The Annals of Thoracic Surgery
    3440 Market Street
    Suite 306
    Philadelphia, PA 19104-3325
    Tel: (215) 349-5542
    FAX: (215) 614-0416

    For submissions on or after February 1, 2015:

    G. Alexander Patterson, MD
    Editor, The Annals of Thoracic Surgery
    The Society of Thoracic Surgeons
    633 N St. Clair Street, 23rd Floor
    Chicago, IL 60611-3658
    Tel: (312) 202-5808
    FAX: (312) 268-5263

    Table of Contents

    1. General Description of Content
    2. Mechanics of Submitting a Manuscript
    3. General Information for Formatting Manuscripts
    4. Categories of Manuscripts and Word Limits
    5. Order of Content Within Manuscripts
         Title Page
         Acknowledgments and Disclosures
         Figure Legends
    6. Protection of Human and Animal Subjects
    7. Conditions for Publication Form
    8. Miscellaneous

    1. General Description of Content

    The Annals of Thoracic Surgery publishes original articles on topics in thoracic and cardiovascular surgery and features such as case reports, "how to do it" articles, image reports, new technology evaluations, STS workforce reports, guidelines, review articles, articles on our surgical heritage, special reports, book reviews, invited editorials, correspondence, commentary and four Continuing Medical Education (CME) activities each month. The electronic issue of the journal posted at is the journal of record.

    2. Mechanics of Submitting a Manuscript

    • All manuscripts, correspondence, and editorial material must be submitted to the online editorial office at Authors must register with an e-mail address and password to submit manuscripts online. Unregistered authors can "create a new account" (ie, register) by following the instructions at the editorial office website. The registration process requires registrants to create a password which is used thereafter to access the website.
    • Every submission, regardless of category, must include: a cover letter, indicating the category of article (see below); the complete manuscript, including title page, abstract, text, tables, acknowledgments, required disclosures (see below), references and illustrations. All of this material is entered via the editorial office website,
    • A "Conditions for Publication Form," which includes disclosures of individual conflicts of interest; sources of funding; scientific responsibility; and freedom of investigation, must be signed by all authors. A copy of this form follows "Information for Authors."
    • Written permission from the publisher (copyright holder) is required to reproduce any previously published table(s); illustrations(s) or photograph(s) in both print and electronic media. Written permission from unmasked patients appearing in photographs is also required.
    • The signed "Conditions for Publication Form," permission letters, and other supplemental material (but not cover letter) should be sent by surface mail or fax to the editorial office at the address above.

    3. General Information for Formatting Manuscripts

    • Submit manuscripts, prepared in Microsoft Word, through the editorial office website after signing in or creating a new account. Enter the "Author Area" and follow the instructions for submitting "Entry data," a cover letter, a complete manuscript file, including abstract and tables, if any, and figure files, if any. Each figure needs to be uploaded according to the specifications in "Illustrations" (Section 5) as an image file, separate from the manuscript file. The system will generate a single PDF for review purposes that includes your manuscript file and any image files. Please see "Order of Content Within Manuscripts" (Section 4) for all of the elements to be included in the manuscript you submit for review.
    • In addition to the uploading of your manuscript file and any image files, separate entry of some metadata (defined as the manuscript title, author names, abstract, etc.) is required during the online submission process. Thus, be sure to enter the metadata where asked, but also to include this information within your manuscript file as well.
    • Under "Entry data," indicate the number of authors in the box and justify more than 10 authors.
    • Arrange manuscript as follows: (1) title page, (2) abstract, (3) text, (4) acknowledgments, (5) disclosures if required, (6) references (do not use EndNotes), (7) tables and (8) figure legends. Number pages consecutively, beginning with the title page as page 1 and ending with the page of figure legends. Do not number manuscript lines. Do not embed tables in the text.
    • Manuscripts should be typed double-spaced throughout (including title page, abstract, text, references, tables, and legends) with one (1) inch (2.5 cm) margins all around.
    • Microsoft Word is the preferred software program. Manuscripts written in 11 point Arial or Times New Roman fonts are preferred and more reliably convert to PDF files during electronic submission. (Note: Do not submit your manuscript in PDF format, which cannot be processed by the editorial office online manuscript tracking system.)
    • American rather than British spelling should be used throughout the manuscript, including that within illustrations.

    4. Categories of Manuscripts and Word Limits

    Original articles should not exceed 4500 words, which includes all words and number sequences submitted regardless of location within the manuscript. The counted words include title page, abstract, text, acknowledgments, disclosures, tables, figure legends and references. The number of references should not exceed 40. All words and number sequences that will appear in the printed article are included in the word count.
    New Technology articles are limited to 2500 words including title page, abstract, text, acknowledgments, disclosures, tables, figure legends and references. The number of tables should not exceed three; the number of illustrations should not exceed six if tables are included; eight, if there are no tables. The number of references should not exceed 10. All New Technology papers require an Acknowledgment, which discloses funding sources and includes a freedom of investigation statement.
    Case reports and "how to do it" articles are limited to a total of 1500 words including title page, abstract, text, acknowledgments, disclosures, figure legends and references. These reports should not include tables; if essential a table should be justified in the cover letter and not have more than four columns and eight rows. The word count of the table is included in the 1500 word limit. Case reports should not be combined with "reviews of the literature." References are limited to eight. A "how to do it" article should be a description of a useful surgical technique and contain descriptive, illustrative material describing the innovation.
    Images in cardiothoracic surgery are limited to 300 words including title page, text and references, and to two, possibly three, figures. The entire contribution must fit on one printed page of The Annals.
    Guidelines, Consensus Documents and Reviews
    Guidelines are usually, but not exclusively developed by the Workforce on Evidence Based Surgery. Guidelines, but not consensus documents or reviews, will have an Executive Summary that includes “levels of evidence” for recommendations after the list of author names in lieu of an abstract. The Executive Summary may be up to 1000 words (which are included in the word count limit). The total word limit for guidelines is 6500 words and the number of references should not exceed 80. Peer review is at the discretion of the editor. The final document must be endorsed by the STS Board of Directors, which will appear as a footnote on the first page. Consensus documents originate from one or more self-appointed experts and require commercial funding to cover page costs. These documents do not require prior approval of the STS, but are peer reviewed. The format of the article or articles is that of a review article. Word limits are negotiable. Reviews originate with authors and are peer reviewed. The total word limit is 6500 words and the number of references should not exceed 80. The unstructured abstract is limited to 100 words (which are included in the word limit). Reviews must have a "Methods" section that describes the sources (databases, prior publications, etc.) that were searched. Topics should be reasonably broad (as opposed to rare diseases) and preferably ones about which there is doubt or controversy regarding management. Authors should seek to integrate data learned from the review and not merely provide one line précis of prior publications.
    Surgical Heritage articles are limited to 4500 words and describe breakthrough achievements which created and directly led to new surgical therapy for thoracic diseases. These articles may or may not include biographical précis of the architects of the achievement. The category is designed to interest our entire readership and therefore does not include tributes; anecdotes of isolated procedures which were not further developed; or vignettes of interesting history or discovery. Memorials are limited to past presidents of the STS and are published as Surgical Heritage articles. Memorials are limited to 2500 words and two photographs. Authors are chosen by the STS Board of Directors. Authors are asked to include contributions to the STS of the deceased during his or her ascent to office as well as achievements during and after leaving the presidency.
    Correspondence (Letters to the Editor) and commentaries are limited to 500 words. Do not include tables and subtract 100 words for each illustration.
    Editorials are limited to 2500 words including references. Subtract 100 words for each illustration and 300 words for each table.

    5. Order of Content Within Manuscripts

    (Items in order from front to back; pages must be numbered; double spacing is required)
    Title Page (first page)
    Title. The title is limited to 100 characters and spaces for original articles and to 80 characters and spaces for all other categories of manuscripts. The title may not contain acronyms or abbreviations. All submissions, except commentaries, must have a title.
    Running Head. Supply a short title of 40 characters or less (including spaces).
    Authors. List all authors by first name, all initials, family name and highest earned academic degree (eg,MD)or degrees (eg,MD,PhD).
    Institutions and Affiliations. List the name and full address of all institutions in which the described work was done. List departmental affiliations of each author affiliated with that institution after each institutional address. Connect authors to departments using numbered superscripts.
    Meeting Presentation. If the paper has been or is to be presented at the annual meeting of The Society of Thoracic Surgeons or the Southern Thoracic Surgical Association, provide the name, location, and dates of the meeting.
    Keywords. Provide up to 5 keywords selected from the "Keyword List" which follows the "Information for Authors" in print and online to describe the manuscript. Do not use any keywords that are not on the list. Be sure to select the keywords from the list provided as part of the online submission process.
    Word Count. Provide the electronic total word count of the entire manuscript including title page, abstract, text, acknowledgments, disclosures, tables, figure legends and entire reference list. Do not omit any words or number sequences in the word count that will appear in the published document.
    Corresponding Author. Provide the name, exact postal address with zip or postal code, telephone number, fax number and e-mail address of the author to whom communications and requests for reprints should be sent after publication. The corresponding author must have a graduate degree; accept responsibility for the integrity of the submitted work; and attest that no undisclosed authors contributed to the manuscript.
    Abstract (second page)
    Original articles. Provide a structured abstract, no longer than 250 words, divided into four sections: Background, Methods, Results, and Conclusions. These subject headings are not part of the following sentence, which must be a complete sentence. Avoid abbreviations and acronyms. Indicate the abstract word count below the abstract.
    New Technology. Provide a structured abstract, no longer than 175 words, divided into four sections: Purpose, Description, Evaluation, and Conclusions. Avoid abbreviations and acronyms. Indicate the abstract word count below the abstract. Case reports, "how to do it" articles, review articles, and our surgical heritage articles. Provide an unstructured abstract of no more than 100 words.
    Images, correspondence, commentaries and editorials. No abstract is required.
    Text (third page, after title page and abstract and continuing up to "Acknowledgments")
    Text should be organized as follows: Introduction, Patients and Methods (or Material and Methods), Results, and Comment.
    Cite references, illustrations, and tables in numeric order by order of mention in the text.
    Avoid abbreviations. Consult the American Medical Association Manual of Style, 10th edition, for recommended abbreviations. Define abbreviations at first appearance in the text. If 8 or more abbreviations or acronyms are used, provide a separate table of abbreviations and acronyms.
    Measurements and weights should be given in standard metric units.
    Statistical nomenclature and data analysis. Follow the "Guidelines for Data Reporting and Nomenclature" published in The The Annals of Thoracic Surgery (1988;46:260.1). Statistical models and formulas used in the analysis of data should be stated in the last paragraph(s) of "Patients and Methods."
    Footnotes. Type footnotes at the bottom of the manuscript page on which they are cited.
    Suppliers. Credit suppliers of drugs, equipment, and other commercial material mentioned in the article within parentheses in text by providing the company name, city and state or city and country if outside the United States.
    Acknowledgments and Disclosures
    Grants, financial support and technical or other assistance are acknowledged at the end of the text before the references. All financial support for the project must be acknowledged and will be printed in the article. Conflict of interest disclosures are indicated on the "Conditions for Publication Form," which must be completed by all authors. This information will appear in a conflict box at the bottom of the first printed page of the article.
    A disclosure statement is required for all studies that received financial, property or intellectual aid from a commercial source for all categories of articles printed in The Annals. The disclosure statement must state the source(s) of all funds used to support the study or to perform an evaluation and whether or not property or tested technology was purchased, borrowed or donated to the study. In addition, the authors must state that they had full control of the design of the study, methods used, outcome parameters and results, analysis of data and production of the written report. These statements are mandatory for all articles and conflicts of interest disclosures are published with the article. (See the "Conditions for Publication Form" for definitions of financial support and freedom of investigation. Note that undisclosed authors must be identified on the "Conditions for Publication Form.")
    Identify references in the text using Arabic numerals in brackets on the line (do not use superscripts or EndNotes). Do not cite personal communications, manuscripts in preparation, and other unpublished data as references.
    Type references double-spaced after text or acknowledgments beginning on a separate sheet. Number consecutively in the order in which they appear in the text. The references must not be linked to the manuscript with EndNotes because that formatting is not compatible with automated publication production processes.
    Journal references should provide inclusive page numbers; book references should cite specific page numbers.
    Authors are solely responsible for accuracy, completeness and non-duplication of references and for the correct spelling of names of all authors.
    Journal abbreviations should conform to those used in Index Medicus. The style and punctuation of the references should follow the formats outlined in the examples below:
    Journal Article
    8. McKhann GM, Selnes OA, Grega MA, Bailey MM, Baumgartner WA, Zeger SL. Subjective memory symptoms in surgical and nonsurgical coronary artery patients: 6-year follow-up. Ann Thorac Surg 2009;87:27.35.
    (List all authors if 6 or fewer; otherwise list first 3 and add "et al.")
    Chapter in Book
    12. Vinten-Johansen J, Zhao Z-Q, Guyton RA. Cardiac surgical physiology. In: Cohn LH, Edmunds LH Jr, eds. Cardiac Surgery in the Adult. 2nd ed. New York, NY: McGraw-Hill; 2003:53.84.
    Internet Address
    3. 1996 NRC Guide for the Care and Use of Laboratory Animals. Available at Accessed November 9, 2011.
    Tables should be typewritten double-spaced on separate sheets (one to each page). Do not use vertical lines. Each table should be numbered (Arabic) and have a title above. Legends and explanatory notes should be placed below the table. Abbreviations used in the table follow the legend in alphabetic order. Lower case letter superscripts beginning with "a" and following in alphabetic order are used for notations regarding statistics. Exact p values must be used; "NS" is obsolete. Tables should be self-explanatory, and tabulated data should not be duplicated in the text or illustrations. Tables must be submitted as part of the text file and not as illustrations.
    Figure Legends
    Figure legends should be numbered (Arabic) and typed double-spaced in order of appearance beginning on a separate sheet. Identify (in alphabetical order) all abbreviations appearing in the illustrations at the end of each legend. Give the type of stain and magnification power for all photomicrographs.
    Cite the source of previously published (print or electronic) material in the legend and indicate permission to republish has been obtained. Proof of permission must be surface mailed or faxed to the editorial office once the manuscript is submitted online.
    Images or figures are submitted online as one or more separate files that may contain one or more images. Within each file containing images, use the figure number (eg, Figure 1A) as the image filename. The system accepts image files formatted in TIFF, JPG and EPS. Powerpoint (.ppt) files are also accepted, but you must use a separate Powerpoint image file for each Powerpoint figure. Please obtain technical help if you are unfamiliar with image files. Call The Annals editorial office (215-349-5542) during business hours 9 am.5 pm, Eastern time U.S., Monday through Friday, if you cannot obtain technical help.
    Illustrations may not be separately copyrighted or have acopyright logo. Illustrations may have a discrete signature of the artist if permitted by the payer of the illustrative work. As a condition for publication copyright for all art is ceded to The Society of Thoracic Surgeons.
    Symbols, letters, numbers and contrasting fills must be distinct, easily distinguished and clearly legible when the illustration is reduced in size. Most illustrations will be reproduced at a width of one column (8.25 cm; 3-1/4 inches).
    Black, white and widely crosshatched bars are preferable; do not use stippling, gray fill or thin lines.
    Written permission for publication from unmasked patients appearing in photographs must be obtained by the authors and must be surface mailed or faxed to the editorial office once the manuscript is submitted online.
    Color illustrations. Color illustrations no longer incur a color surcharge and are usually preferable over black and white illustrations. All photomicrographs must be submitted in color.
    Original illustrations. If your manuscript is accepted for publication and the electronic art you have submitted online is not acceptable for reproduction purposes, you may be required to send a set of original illustrations to the editorial office. You will be instructed accordingly by the staff. These illustrations will not be returned.

    6. Protection of Human and Animal Subjects

    Human Investigation
    Institutional Review Board (IRB) or Ethics Committee (EC) or comparable group must approve all articles that contain information about human subjects. The local IRB also decides whether or not patient consent is required or waived. The IRB or EC, not the author, makes review decisions for every study involving human subjects or information about human subjects. The investigator should retain and not submit the decision letter granting IRB approval. Study approval and patient consent or waiver of the need for consent must be stated in the first paragraph under "Patients and Methods."
    Humane Animal Care
    When animals are used as subjects, institutional approval of the protocol is necessary and authors should include a statement in "Methods" indicating that investigators complied with the 1996 "Guide for the Care and Use of Laboratory Animals" (See, recommended by the U.S. National Institutes of Health, or with equivalent guidelines administered by the author's governmental regulatory body. When no formal ethics review process is available, authors must state that humane care was provided in animal experiments, in accordance with either of the above guidelines.

    7. Conditions for Publication Form

    • The Society of Thoracic Surgeons and The Annals require all authors to adhere to the highest ethical standards of our profession. Ethical breaches include scientific misconduct (falsification or fabrication), plagiarism and redundant publication and are described more fully in Ann Thorac Surg 1999;68:1; Ann Thorac Surg 2007;84:717-9; and Ann Thorac Surg 2012;93-1.
    • Before publication of an accepted manuscript each author is required to certify by signing the “Conditions for Publication Form” that he or she has participated sufficiently in the work to take responsibility for a meaningful share of the content of the manuscript as described more specifically in the preamble of the form. The “Conditions for Publication Form” also covers: conflicts of interest, freedom of investigation, exclusive publication, undisclosed authorship, and copyright transfer.

    8. Miscellaneous

    NIH Initiative
    The United States National Institutes of Health requires that all investigators funded by the NIH submit or have submitted for them an electronic version of their final, peer-reviewed manuscripts upon acceptance for publication. The electronic manuscript is sent to the National Library of Medicine's PubMed Central (, where it is made publicly available no later than 12 months after the official date of publication (
    Randomized Controlled Trials
    The Annals of Thoracic Surgery endorses the CONSORT Statement regarding randomized controlled trials ( and recommends that investigators who plan to publish their work in The Annals review the CONSORT E-Flowchart and Checklist (available at before enrollment of subjects begins. Randomized controlled trials should be free of bias and of misleading information due to, for example, insufficient numbers of subjects and failure to define primary and secondary endpoints. The Checklist succinctly and comprehensively defines the attributes of a well-designed and reported randomized controlled trial. Authors who submit reports of randomized controlled trials to The Annals should also submit a completed CONSORT Flowchart and Checklist, leaving blank the page number of any item that wasn't done as part of the study; no study is expected to have addressed all the items on the checklist. These documents are intended to be used for review purposes only, and will not be published.
    Registration of Clinical Trials
    The Annals of Thoracic Surgery supports mandatory registration of all publicly or commercially funded clinical trials, including Phase I and II trials, as a condition for publication. Information regarding requirements for registration of a clinical trial may be found at Information for registering a clinical trial is available at The trial registration number should appear at the end of the abstract.
    Archiving Submissions in Editorial Office Online Manuscript Tracking System
    The editorial office will delete unpublished manuscripts from the online system 6 months after the final decision is rendered. Manuscripts of published articles will be deleted 12 months after acceptance.

    Required supplementary data to be surface mailed or faxed to the editorial office:

    • The "Conditions for Publication Form" signed by all authors with appropriate boxes checked.
    • Written permission from the publisher to reproduce previously published illustrations or tables.
    • Written permission from unmasked patients appearing in photographs.

    Click here for a PDF of the keyword list.Updated January 2015


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