Yearly volume of cardiac procedures in the National Inpatient Sample (NIS) per 1 million U.S. adult population from 1998 to 2013. To calculate incidence of cardiac procedures per 1 million, yearly estimates of each procedure type were divided by the yearly U.S. population estimate based on U.S. Census Bureau data (http://www.census.gov/popest/data/historical/index.html). Results are nationwide estimates using NIS weighting and STATA (StataCorp LLC) survey function. There was a 60% decrease in coronary artery bypass graft (CABG) as the sole procedure from 1998 to 2013 (1,725 to 686 per million adults), 1,092% increase in left ventricular assist device (LVAD; 1.3 to 14.2 per million), 53% increase in valve replacement alone (206 to 315 per million), and a 22% decrease in combined CABG valve (176 to 137 per million; P = 0.0001). Cardiac procedure types include (A) CABG only, (B) valve repair or replacement only (Valve only), (C) CABG valve repair or replacement (CABG-Valve), and (D) LVAD. Error bars are 95% CIs.