How many open (surgical) aortic valve replacement procedures are performed annually in the United States?

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Last updated: July 27, 2026 • View editorial policy

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Annual Volume of Open Aortic Valve Replacement Surgeries in the United States

Based on the most recent guideline data available, approximately 9,000 to 12,000 isolated open surgical aortic valve replacements (SAVR) are reported annually to the Society of Thoracic Surgeons (STS) voluntary database, though this represents only a fraction of actual national practice. 1

Understanding the Data Limitations

The available numbers come from the STS voluntary registry, which received reports of 9,108 to 11,665 isolated AVRs per year during 1999-2004 (totaling 62,834 operations over this period). 2 The 2008 guidelines explicitly acknowledge that "this voluntary registry is not inclusive of national practice, but it represents the best approximation currently available." 1

Key Context About These Numbers:

  • These figures represent only isolated AVR procedures (valve replacement alone, without concurrent procedures like CABG)
  • The voluntary nature means many centers do not report, so actual national volumes are substantially higher
  • Published data represents only a small fraction of valves actually implanted 2

Evolution of Surgical Practice

The landscape has shifted dramatically since these guideline data were collected:

Historical trends from 2011-2014 showed declining isolated SAVR volumes at high-volume TAVR centers, with annual volumes dropping from 2,607 to 1,791 at the highest-volume quartile hospitals. 3 This reflects the growing adoption of transcatheter approaches for appropriate candidates.

More recent data (2015-2020) documented 68,956 patients undergoing traditional sternotomy and 23,811 undergoing minimally invasive approaches over this 6-year period, suggesting approximately 15,000-18,000 open AVR procedures annually when extrapolating from this surgical database. 4

Important Caveats

  • The true national volume is likely 20,000-30,000+ procedures annually when accounting for:

    • Non-reporting centers to voluntary registries
    • Combined procedures (AVR + CABG, AVR + ascending aorta replacement)
    • Regional variation in reporting practices

  • TAVR has fundamentally altered the surgical landscape since 2011, progressively reducing SAVR volumes as transcatheter technology has expanded to lower-risk populations 3

  • The most reliable historical benchmark remains the STS database showing 9,000-12,000 isolated procedures annually in the early 2000s, but this significantly underestimates total national practice 1

References

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