Best Hospitals for Heart Valve Replacement in the United States
How Top Hospitals Are Ranked for Heart Valve Care
The most widely referenced framework for identifying the best hospitals for heart valve replacement in the United States comes from U.S. News and World Report, which evaluates nearly 4,500 facilities annually for its Best Hospitals rankings. 1 For the Cardiology, Heart and Vascular Surgery specialty list, scores are calculated using patient outcomes (45%), hospital structure (35%), expert opinion surveys (12%), patient experience scores (5%), and participation in public transparency initiatives (3%). 2 This methodology creates a multidimensional performance profile rather than relying on a single metric, making it a broadly accepted reference for patients navigating complex cardiac care decisions.
The Society of Thoracic Surgeons (STS) operates a separate National Database that tracks surgical outcomes across cardiothoracic programs and awards three-star composite quality ratings to top performers. 3 Cleveland Clinic, for example, received the highest STS three-star composite rating for isolated aortic valve replacement, isolated mitral valve repair, and coronary artery bypass grafting for the three-year period ending June 2025. 4 The Centers for Medicare and Medicaid Services also publish hospital quality measures through a public reporting platform, allowing patients to cross-reference institutional performance on cardiac procedures covered under Medicare. 5
The 2025-2026 Leading Institutions by National Rankings
According to the 2025-2026 U.S. News rankings for Cardiology, Heart and Vascular Surgery, NYU Langone Hospitals in New York City holds the top position, displacing Cleveland Clinic, which had ranked number one for five consecutive years and now sits at number three. 2 Mount Sinai Hospital ranks second, while New York-Presbyterian Hospital (Columbia and Cornell) ranks fifth, Cedars-Sinai Medical Center ranks sixth, Northwestern Medicine-Northwestern Memorial Hospital ranks seventh, Massachusetts General Hospital ranks eighth, the Hospitals of the University of Pennsylvania-Penn Presbyterian rank ninth, and Johns Hopkins Hospital ranks tenth. 1 Mayo Clinic in Rochester, Minnesota, holds the fourth position on the national list.
Procedural volume data provides a complementary dimension to overall rankings. Using the Definitive Healthcare Atlas All-Payor Claims Dataset tracking 2024 procedures, Mayo Clinic Hospital-Saint Mary's Campus led all U.S. institutions in transcatheter aortic valve replacement (TAVR) volume, accounting for 1.05% of all tracked U.S. procedures. 6 Cleveland Clinic Main Campus followed at 0.79%, Tisch Hospital (NYU Langone) at 0.77%, The Mount Sinai Hospital at 0.74%, Piedmont Atlanta Hospital at 0.70%, and Cedars-Sinai Medical Center at 0.68%. 6 High procedural volume is considered a meaningful proxy for institutional expertise in structurally complex cardiac interventions.
Procedure Types Available at Leading Centers
Top-tier valve centers offer a spectrum of replacement and repair approaches tailored to individual patient anatomy, age, and risk profile. Traditional open surgical aortic valve replacement (SAVR) remains a standard of care at institutions like Cleveland Clinic, where the observed operative mortality for isolated aortic valve replacement in 2025 was 0.0%, compared to the STS expected rate of 1.6%. 4 Minimally invasive options, including robot-assisted surgery, are available at institutions such as Mayo Clinic, where surgeons use robotic arms and 3D magnified visualization through a remote console, with a secondary surgical team assisting at the operating table. 7
Transcatheter procedures have expanded the treatment population significantly. The TAVR technique, which delivers a replacement valve through a catheter inserted via the femoral artery or chest wall, has become the preferred method for aortic valve replacement at many high-volume centers, surpassing traditional surgical approaches due to its reduced invasiveness for older or higher-risk patients. 6 Penn Medicine, ranked among the nation's top valve programs and described as the largest in the mid-Atlantic region, reports a mitral valve repair rate of nearly 100%, far above the national average, and was the first institution in the region to offer advanced catheter-based nonsurgical intervention. 8 Transcatheter mitral valve replacement (TMVR) and transcatheter pulmonary valve replacement (TPVR) are also available at select quaternary care centers for patients who are not candidates for open surgery. 8
Clinical Evidence on Outcomes: TAVR Versus Surgical Approaches
A major Phase III clinical trial involving 1,000 patients at 71 healthcare locations, known as the international PARTNER 3 trial, found that health outcomes at seven years post-treatment were similar for patients who underwent TAVR compared to those who had open-heart surgery, with no significant differences in mortality, stroke, or rehospitalization. 9 The study, co-authored by Raj Makkar, MD, of Cedars-Sinai's Smidt Heart Institute, was published in The New England Journal of Medicine and represents among the longest follow-up data available for comparative valve replacement approaches. 9 Aortic valve disease affects approximately 2% of the U.S. population, with risk rising with age, making this long-term data increasingly relevant as the patient population grows. 9
For patients with bicuspid aortic stenosis, a separate multicenter observational study analyzing 997 patients found that the one-year composite outcome rate was 15.0% for TAVR versus 12.0% for SAVR (hazard ratio 1.35, 95% CI 0.83-2.19, P=0.23), indicating no statistically significant difference at one year. 10 However, at two years, TAVR showed significantly higher rates of both valve dysfunction (subdistribution HR 4.16, P=0.03) and stroke (subdistribution HR 3.01, P=0.02) in this subgroup, underscoring that procedure selection for bicuspid anatomy warrants careful multidisciplinary review. 10
What to Consider When Evaluating a Heart Valve Program
Patients evaluating institutions for heart valve replacement should look beyond composite rankings to assess procedure-specific volume, complication rates, and the availability of a multidisciplinary heart team. Research published in Baylor University Medical Center Proceedings in 2025 found that multidisciplinary heart team evaluation facilitates individualized treatment strategies by distinguishing patients who may benefit from intervention despite high procedural risk, while identifying those unlikely to benefit from immediate intervention. 11 This team-based structure, involving cardiac surgeons, interventional cardiologists, imaging specialists, and anesthesiologists, is a hallmark of programs recognized by organizations such as the American College of Cardiology and The Joint Commission. 5
The STS Public Reporting platform allows patients to review three-star rated cardiac surgery programs by geographic region, providing a standardized, audited benchmark independent of media rankings. 3 Programs recognized on Becker's Healthcare annual list of 100 hospitals with great heart programs are assessed through editorial research and nominations, evaluating clinical excellence, research output, and the use of advanced structural heart technologies. 12 Patients with complex anatomies or prior valve procedures may also benefit from seeking centers actively enrolled in clinical trials, which provide access to investigational devices and techniques not yet broadly available.
Risks, Eligibility Factors, and Long-Term Maintenance
Heart valve replacement carries procedural risks that vary significantly based on patient age, comorbidities, and the specific valve and technique used. For reoperative scenarios involving failed bioprosthetic mitral valves, a multicenter cohort study published in the Annals of Thoracic Surgery found that while 30-day outcomes were comparable between transcatheter valve-in-valve (mViV) and reoperative surgical mitral valve replacement (rSMVR), the five-year mortality rate was substantially different: 20.3% for rSMVR versus 40.9% for mViV among patients deemed appropriate for surgery by a multidisciplinary team. 13 Mean mitral valve gradients at five years were also significantly better with surgery (5.3 mm Hg versus 9.8 mm Hg, P less than 0.001). 13
Eligibility for specific procedures depends on anatomical suitability, overall surgical risk scores such as STS-PROM, and patient age. Replacement heart valves may last 15 years or longer but do not always last a lifetime, meaning patients may require reintervention. 8 The EARLY TAVR trial found that early TAVR was superior to clinical surveillance in asymptomatic severe aortic stenosis across all age groups studied (65 to 80-plus years), with the greatest absolute reduction in stroke occurring in patients aged 65 to 69 and 80 or older. 14 Patients and their physicians must weigh short-term procedural risk against long-term hemodynamic durability and quality-of-life outcomes when selecting both the institution and the approach.
Sources
- U.S. News and World Report - 2025-2026 Best Hospitals for Cardiology, Heart and Vascular Surgery (health.usnews.com)
- Cardiovascular Business - The Best Heart Hospitals in the United States (cardiovascularbusiness.com)
- Society of Thoracic Surgeons - National Database and Public Reporting (sts.org)
- Cleveland Clinic Consult QD - Vital Statistics in Adult Cardiac Surgery, Including Valve and Aorta Operations (consultqd.clevelandclinic.org)
- Centers for Medicare and Medicaid Services - Hospital Quality Compare (medicare.gov)
- Definitive Healthcare - Top 10 Hospitals Performing TAVR Procedures (definitivehc.com)
- Mayo Clinic - Heart Valve Surgery Care at Mayo Clinic (mayoclinic.org)
- Penn Medicine - Heart Valve Disease Care and Mitral Valve Repair and Replacement Surgery (pennmedicine.org)
- Cedars-Sinai Newsroom - Minimally Invasive Procedure for Aortic Valve Disease Has Similar Outcomes as Surgery (cedars-sinai.org)
- Journal of the American Heart Association - Surgical Versus Transcatheter Aortic Valve Replacement in Bicuspid Aortic Stenosis (doi.org/10.1161/jaha.125.045763)
- Baylor University Medical Center Proceedings - Insights from a Multidisciplinary Heart Team for Highest-Risk Valve Disease (2025)
- Becker's Hospital Review - 100 Hospitals and Health Systems With Great Heart Programs 2025 (beckershospitalreview.com)
- Annals of Thoracic Surgery - Long-Term Survival Advantage of Reoperative Surgical Mitral Valve Replacement Over Transcatheter Mitral Valve-in-Valve (annalsthoracicsurgery.org)
- Circulation Cardiovascular Interventions - Age and Procedural Timing for Asymptomatic Severe Aortic Stenosis: Analysis From the EARLY TAVR Trial (2026)