Cleveland Clinic · Decision guide
Cleveland, Ohio, United States · Distinct teams for mitral repair, HCM and complex valve reconstruction
Cleveland’s cardiac services bring together different expertise: Gillinov’s mitral/robotic work, Smedira’s myectomy practice, Kapadia’s catheter valve treatment and Unai’s endocarditis and redo reconstruction. Its published cohorts show why valve anatomy and supporting tissues can matter as much as the incision.
The 2005–2015 series included 522 operations combining myectomy with mitral or subvalvular treatment.
The 2006–2013 series completed 992 repairs in 997 attempts among 1,000 robotic mitral operations.
Sources: Early results of robotically assisted mitral valve surgery: Analysis of the first 1000 cases
Official profiles separately identify Kapadia’s TAVR work and Unai’s endocarditis and complex repeat-surgery practice.
Sources: Samir Kapadia, MD · Shinya Unai, MD — cardiac surgery profile
Programme operations · Calendar year 2024 · published 2025-08-27 · counting date 2024-12-31
Programme total across septal approaches, including operations with associated procedures.
Cleveland Clinic 2024 HOCM data highlights ↗ · source read 2026-10-08Programme operations · Calendar year 2025 · published 2026-03-16 · counting date 2025-12-31
Isolated mitral valve repair; all approaches.
Cleveland Clinic 2025 adult cardiac surgery volumes and outcomes ↗ · source read 2026-10-08Programme operations · Calendar year 2025 · published 2026-03-16 · counting date 2025-12-31
Isolated mitral valve replacement; all approaches.
Cleveland Clinic 2025 adult cardiac surgery volumes and outcomes ↗ · source read 2026-10-08Programme operations · Calendar year 2025 · published 2026-03-16 · counting date 2025-12-31
Isolated mitral valve repair or replacement; all approaches. Calculated from 447 repairs + 167 replacements in the same isolated-procedure table.
Cleveland Clinic 2025 adult cardiac surgery volumes and outcomes ↗ · source read 2026-10-08Programme operations · Cumulative at podcast date; start not assigned · published 2025-02-25 · counting date 2025-02-25
Robotically assisted mitral valve procedures.
Advances in Heart Surgery at Cleveland Clinic — Part I ↗ · source read 2026-10-08Personal participation · Cumulative participation; myectomy-specific start and cutoff not stated
The institutional profile attributes participation in septal myectomies to Smedira; it does not allocate all cases to him as sole operator.
Dr. Nicholas Smedira, MD – Cleveland, OH – Cardiac Surgery – Request Appointment ↗ · source read 2026-10-08Programme operations · 2002–2021; exact boundary dates not specified
Cleveland programme experience across 2002–2021, described by Milind Desai in an official clinical discussion. It is separate from Smedira’s personal participation count.
Surgical Myectomy for Hypertrophic Cardiomyopathy ↗ · source read 2026-10-08Your diagnosis, selected specialist and treatment priorities.
Sources: Surgical management of left ventricular outflow tract obstruction in a specialized hypertrophic obstructive cardiomyopathy center · Early results of robotically assisted mitral valve surgery: Analysis of the first 1000 cases · Samir Kapadia, MD · Shinya Unai, MD — cardiac surgery profile · Mitral and Tricuspid Valve Center · Robotically Assisted Mitral Valve Repair: Patient Applications Grow · Nicholas Smedira — current clinical profile · Transcatheter or Surgical Aortic-Valve Replacement in Low-Risk Patients at 7 Years. · The Hidden Burden of Native Aortic Valve Endocarditis: Reevaluating Diagnostic and Pathologic Challenges. · Mitral valve abscess: echocardiographic imaging, microbiology, management, and outcomes.
Sources: Surgical management of left ventricular outflow tract obstruction in a specialized hypertrophic obstructive cardiomyopathy center · Early results of robotically assisted mitral valve surgery: Analysis of the first 1000 cases · Samir Kapadia, MD · Shinya Unai, MD — cardiac surgery profile · Mitral and Tricuspid Valve Center · Robotically Assisted Mitral Valve Repair: Patient Applications Grow · Nicholas Smedira — current clinical profile · Transcatheter or Surgical Aortic-Valve Replacement in Low-Risk Patients at 7 Years. · The Hidden Burden of Native Aortic Valve Endocarditis: Reevaluating Diagnostic and Pathologic Challenges. · Mitral valve abscess: echocardiographic imaging, microbiology, management, and outcomes.
Cleveland, Ohio · United States
cardiac surgeon
A. Marc Gillinov’s Cleveland Clinic practice focuses on mitral repair and robotic mitral surgery. He also leads surgical atrial-fibrillation work, a relevant combination when a leaking valve and an abnormal rhythm occur together.
Sources: A. Marc Gillinov, MD | Cleveland Clinic · Early results of robotically assisted mitral valve surgery: Analysis of the first 1000 cases
Cleveland, Ohio · United States
cardiac surgeon
Nicholas Smedira is a Cleveland Clinic myectomy specialist. The centre’s HCM evidence is particularly informative when obstruction involves the mitral valve or its supporting muscles alongside a thickened septum.
Sources: Nicholas Smedira, MD — Cleveland Clinic · Surgical management of LVOT obstruction in a specialized HOCM center
Cleveland, Ohio · United States
interventional cardiologist
Samir Kapadia is a Cleveland Clinic interventional cardiologist whose practice includes TAVR and other percutaneous valve treatments. His role is catheter therapy within a heart team; surgical valve replacement is performed by a cardiac surgeon.
Sources: Samir Kapadia, MD · Transcatheter or Surgical Aortic-Valve Replacement in Low-Risk Patients at 7 Years.
Cleveland, Ohio · United States
cardiac surgeon
Shinya Unai’s Cleveland Clinic practice explicitly includes endocarditis and complex reoperative surgery. Infection can extend beyond a valve into the root or tissue between valves, requiring more extensive reconstruction.
Sources: Shinya Unai, MD — cardiac surgery profile · The Hidden Burden of Native Aortic Valve Endocarditis: Reevaluating Diagnostic and Pathologic Challenges.
Read alongside A. Marc Gillinov’s profile →
1,000 robotic mitral operations. 2006–2013 · published 2017/2018. Reported stroke fell from 2.0% in the first 500 cases to 0.8% in the second 500. This is an unadjusted time comparison, not proof that volume alone caused the change. Hospital and early results, not a long-term durability study.
How to interpret this: Institutional series; Gillinov is first author, without per-surgeon case allocation. The current official programme also names Per Wierup. Screened robotic candidates. Historical figures do not establish current individual outcomes.
Sources: Early results of robotically assisted mitral valve surgery: Analysis of the first 1000 cases
Read alongside Nicholas Smedira’s profile →
1,530 myectomy-containing operations. 2005–2015 · study published 2019. 522 operations combined myectomy with mitral or subvalvular intervention. Those patients had thinner septums on average than patients without mitral intervention. Perioperative outcomes in the primary abstract; no comparable long-term duration extracted.
How to interpret this: Smedira is a currently listed myectomy specialist and study coauthor. The primary abstract says one surgeon, but does not name that operator. These are programme-study results. 1,530 is derived from 586 isolated + 522 with mitral/subvalvular work + 422 with other procedures. Another 29 operations were mitral-only. This is not current annual volume.
Sources: Surgical management of LVOT obstruction in a specialized HOCM center · Nicholas Smedira, MD — Cleveland Clinic
Read alongside Samir Kapadia’s profile →
PARTNER 3 randomized 1,000 low-risk patients with severe symptomatic aortic stenosis. At seven years the report found no significant difference in its two primary composite endpoints involving death, stroke and rehospitalization.
How to interpret this: Selected trial population and a particular transcatheter platform; industry funded. It does not establish lifetime durability, suitability for every anatomy, or Kapadia-specific complication rates.
Sources: Transcatheter or Surgical Aortic-Valve Replacement in Low-Risk Patients at 7 Years.
Read alongside Shinya Unai’s profile →
A 2026 coauthored report describes 154 adults with mitral valve abscess drawn from historical Cleveland databases. Many required complex surgery, including reconstruction of the aortomitral continuity.
How to interpret this: A high-risk referral cohort with variable follow-up, not a contemporary personal success rate. Mortality over all follow-up must not be presented as a fixed-year risk.
Sources: Mitral valve abscess: echocardiographic imaging, microbiology, management, and outcomes.
Read alongside Shinya Unai’s profile →
A separate historical surgical cohort found invasive native aortic infection could be absent from preoperative imaging findings.
How to interpret this: Selected patients who underwent surgery at one tertiary centre; not a rule that imaging is unnecessary or inaccurate in every case.
Cleveland, United States
Nicholas Smedira
Cleveland Clinic HCM Center
Specialist HCM imaging and myectomy that can also correct mitral-leaflet or papillary-muscle causes of obstruction.
Quote on request
Individual estimate after assessment.
A historical series of 1,559 LVOT operations, including 1,530 myectomies and 522 myectomies with mitral or subvalvular intervention.
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