The Texas Medical Center was widely considered the center of innovative heart care a half-century ago, but it took until Tuesday for a Houston program to finally win designation as the best in the nation.
U.S. News & World Report has ranked Texas Children’s Hospital the No. 1 pediatric hospital for cardiology and heart surgery in its new survey, a testament to the Houston hospital’s superior outcomes involving procedures considered unthinkable 25 years ago. The center has become known in recent years as the place to go for complex interventions on tiny hearts.
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"This ranking by U.S. News reaffirms the stature of the Texas Medical Center in cardiovascular care," said Dr. Charles Fraser, Texas Children’s surgeon-in-chief and chief of congenital heart surgery. "I’m extremely proud to help put Houston and the Texas Medical Center back on top."
The U.S. News & World Report rankings had not been created in the 1960s and 1970s, when the pioneering heart procedures of Drs. Michael DeBakey and Denton Cooley transformed Houston into what late author Thomas Thompson called "the cardiovascular surgery center of the world."
In the new rankings, Texas Children’s knocked off Boston Children’s Hospital, long the gold standard for heart care. Texas Children’s moved from No. 4 in 2011 to No. 3 in 2012 to No. 2 in 2014, before this year’s ascension.
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Overall, Texas Children’s remained No. 4 in the survey. Boston Children’s was again No. 1.
Fraser is the man most responsible for Texas Children’s rise as a heart center. After coming to Texas Children’s in 1995, he built a team of top surgeons and instilled an attitude that they could successfully take on the most difficult cases, critiquing and tracking performances as part of the effort to improve outcomes.
Texas Children’s resulting death rate for heart surgery patients in 2016 was 2.2 percent, the lowest in the nation and markedly better than Boston Children’s (2.7 percent). The national rate is 3.1 percent.
The Texas Children’s surgical team performs more than 1,000 open-heart surgeries annually. It performed 25 heart transplants in 2016, the most of any pediatric program in the nation.
The No. 1 ranking also reflects Texas Children’s rise as a center of cardiology. It now annually performs roughly 1,200 cardiac catheterizations, a less invasive treatment made possible by the threading of a long, flexible tube from a blood vessel in the leg to the heart. Most such cases would have required open-heart surgery 20 years ago.
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It also performs about 250 catheter-enabled ablation treatments in children with irregular heartbeats, a treatment that cauterizes the abnormal pathway to correct the problems. Such patients previously required lifelong medication.
"This No. 1 ranking will give us a greater role shaping the field, making the things that are impossible now possible in 2027," said Dr. Dan Penny, Texas Children’s chief of pediatric cardiology. "Although we’re No. 1 this year, we need to be better next year and the year after and the year after that. We can’t rest on our laurels."
Other top-ranked hospitals in the U.S. News survey were Children’s Hospital of Philadelphia at No. 2, Cincinnati Children’s Hospital Medical Center at No. 3 and Johns Hopkins Children’s Center at No. 5.
Besides its No. 1 ranking for cardiology and heart surgery, Texas Children’s was No. 2 for pulmonology, No. 4 for cancer, No. 4 for gastroenterology and gastrointestinal surgery, No. 4 for neurology and neurosurgery, No. 4 for nephrology, No. 6 for diabetes and endocrinology, No. 6 for urology, No. 11 for neonatology and No. 16 for orthopedics.
Two changes in methodology mark the 2017 rankings. U.S. News reduced the weight of a hospital’s reputation and increased the importance of objective data, particularly outcome measures that show how well the hospital performed in ensuring the survival of patients undergoing surgery.
This marks U.S. News’ 11th pediatric rankings. Its 28th adult hospital rankings will be published Aug. 1.