{"schema_version":"bookimed.page-context.v1","id":"doctor-shinya-unai","url":"https://hub.bookimed.com/heart-surgery/doctor-shinya-unai/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/doctor-shinya-unai.json","index_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/index.json","full_dataset_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/content.json","content_revision":"source-driven-rankings-20261008","date_modified":"2026-10-08","language":"en","kind":"doctor-profile","title":"Shinya Unai: endocarditis and complex repeat surgery","summary":"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.","research_credit":{"name":"Yevhenii Kozlov","role":"Co-Founder of Bookimed","url":"https://us-uk.bookimed.com/ceo/kozlov/","contribution":"Research personally prepared and reviewed","assistance":"AI tools assisted source research."},"editorial_scope":"Source-based patient information; an individual treatment plan requires clinical review.","research_method":"How this guide is researched and compared Research project led by Yevhenii Kozlov . We link clinical guidance, primary studies and named hospital or offer sources beside the relevant statements. Comparisons distinguish individual operators from programme results and preserve the study population, follow-up and limitations. Prices are dated examples with their stated scope. Research and editorial preparation are separate from clinical review; no named clinician has medically reviewed this edition. Bookimed provides care coordination. Partner and reference programmes are identified from their sources; paid ordering is not used in our published-cohort comparison. Read the editorial policy .","key_takeaways":[{"label":"Reconstruction beyond one valve","text":"His clinical profile includes endocarditis, repeat surgery, aortic/root surgery and valve repair or replacement.","sources":["SP13"]},{"label":"Imaging can understate invasion","text":"In a historical 644-patient native aortic endocarditis cohort, 260 had invasive disease at surgery; preoperative echo detected invasion in 43% of those cases.","sources":["SP21"]},{"label":"Complex abscess surgery","text":"A 154-adult mitral-abscess cohort reported that 27% required reconstruction of the aortomitral continuity with a Commando procedure.","sources":["SP22"]}],"benefits":[{"text":"His endocarditis and reoperative scope includes reconstruction when infection extends beyond a valve into surrounding tissue.","sources":["SP13","SP21"]}],"limitations":[{"text":"These are high-risk historical referral cohorts, not Unai’s personal outcomes. Recent publication dates do not make the underlying 2002–2020-era patients a contemporary surgical cohort.","sources":["SP13","SP21","SP22"]}],"sections":[{"id":"benefit-balance","title":"Benefits and limitations","text":"Benefits and limitations Potential advantages His endocarditis and reoperative scope includes reconstruction when infection extends beyond a valve into surrounding tissue. Sources: Shinya Unai, MD — cardiac surgery profile · The Hidden Burden of Native Aortic Valve Endocarditis: Reevaluating Diagnostic and Pathologic Challenges. Trade-offs and limits These are high-risk historical referral cohorts, not Unai’s personal outcomes. Recent publication dates do not make the underlying 2002–2020-era patients a contemporary surgical cohort. Sources: Shinya Unai, MD — cardiac surgery profile · The Hidden Burden of Native Aortic Valve Endocarditis: Reevaluating Diagnostic and Pathologic Challenges. · Mitral valve abscess: echocardiographic imaging, microbiology, management, and outcomes.","links":[{"label":"Shinya Unai, MD — cardiac surgery profile","url":"https://providers.clevelandclinic.org/provider/shinya-unai/4268207"},{"label":"The Hidden Burden of Native Aortic Valve Endocarditis: Reevaluating Diagnostic and Pathologic Challenges.","url":"https://pubmed.ncbi.nlm.nih.gov/41482022/"},{"label":"Shinya Unai, MD — cardiac surgery profile","url":"https://providers.clevelandclinic.org/provider/shinya-unai/4268207"},{"label":"The Hidden Burden of Native Aortic Valve Endocarditis: Reevaluating Diagnostic and Pathologic Challenges.","url":"https://pubmed.ncbi.nlm.nih.gov/41482022/"},{"label":"Mitral valve abscess: echocardiographic imaging, microbiology, management, and outcomes.","url":"https://pubmed.ncbi.nlm.nih.gov/42394651/"}]},{"id":"research","title":"Procedure-specific research","text":"Procedure-specific research Abscess disease needs context 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. Imaging may understate reconstruction needs 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. Sources: The Hidden Burden of Native Aortic Valve Endocarditis: Reevaluating Diagnostic and Pathologic Challenges.","links":[{"label":"Mitral valve abscess: echocardiographic imaging, microbiology, management, and outcomes.","url":"https://pubmed.ncbi.nlm.nih.gov/42394651/"},{"label":"The Hidden Burden of Native Aortic Valve Endocarditis: Reevaluating Diagnostic and Pathologic Challenges.","url":"https://pubmed.ncbi.nlm.nih.gov/41482022/"}]},{"id":"team","title":"Clinical programme","text":"Clinical programme Cleveland Clinic → Cleveland, Ohio, United States 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. 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. Explore the programme and other specialists →","links":[{"label":"Cleveland Clinic →","url":"https://hub.bookimed.com/heart-surgery/clinic-cleveland/"},{"label":"Surgical management of left ventricular outflow tract obstruction in a specialized hypertrophic obstructive cardiomyopathy center","url":"https://doi.org/10.1016/j.jtcvs.2018.11.148"},{"label":"Early results of robotically assisted mitral valve surgery: Analysis of the first 1000 cases","url":"https://pubmed.ncbi.nlm.nih.gov/28893396/"},{"label":"Samir Kapadia, MD","url":"https://my.clevelandclinic.org/staff/5003-samir-kapadia"},{"label":"Shinya Unai, MD — cardiac surgery profile","url":"https://providers.clevelandclinic.org/provider/shinya-unai/4268207"},{"label":"Mitral and Tricuspid Valve Center","url":"https://my.clevelandclinic.org/departments/heart/depts/mitral-and-tricuspid-valve-center"},{"label":"Robotically Assisted Mitral Valve Repair: Patient Applications Grow","url":"https://consultqd.clevelandclinic.org/robotically-assisted-mitral-valve-repair-patient-applications-grow"},{"label":"Nicholas Smedira — current clinical profile","url":"https://providers.clevelandclinic.org/provider/nicholas-smedira/4268212"},{"label":"Transcatheter or Surgical Aortic-Valve Replacement in Low-Risk Patients at 7 Years.","url":"https://pubmed.ncbi.nlm.nih.gov/41144631/"},{"label":"The Hidden Burden of Native Aortic Valve Endocarditis: Reevaluating Diagnostic and Pathologic Challenges.","url":"https://pubmed.ncbi.nlm.nih.gov/41482022/"},{"label":"Mitral valve abscess: echocardiographic imaging, microbiology, management, and outcomes.","url":"https://pubmed.ncbi.nlm.nih.gov/42394651/"},{"label":"Explore the programme and other specialists →","url":"https://hub.bookimed.com/heart-surgery/clinic-cleveland/"}]}],"introduction":"Heart surgery guide / Shinya Unai Shinya Unai · Decision guide Shinya Unai: endocarditis and complex repeat surgery Endocarditis and complex repeat cardiac reconstruction · Cleveland, Ohio, United States Research by Yevhenii Kozlov · Co-Founder of Bookimed Updated 8 October 2026 Sources linked throughout At a glance 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. Reconstruction beyond one valve His clinical profile includes endocarditis, repeat surgery, aortic/root surgery and valve repair or replacement. Sources: Shinya Unai, MD — cardiac surgery profile Imaging can understate invasion In a historical 644-patient native aortic endocarditis cohort, 260 had invasive disease at surgery; preoperative echo detected invasion in 43% of those cases. Sources: The Hidden Burden of Native Aortic Valve Endocarditis: Reevaluating Diagnostic and Pathologic Challenges. Complex abscess surgery A 154-adult mitral-abscess cohort reported that 27% required reconstruction of the aortomitral continuity with a Commando procedure. Sources: Mitral valve abscess: echocardiographic imaging, microbiology, management, and outcomes. Portrait source ↗ cardiac surgeon Shinya Unai Cleveland Clinic → Cardiac surgeon, Cleveland Clinic Main Campus Cardiac surgeon, Cleveland Clinic Main Campus · Cleveland, Ohio, United States. Read the clinical or research source ↗","related_documents":[{"id":"heart-surgery","title":"Heart surgery abroad: treatments, clinics and costs","kind":"home","url":"https://hub.bookimed.com/heart-surgery/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/heart-surgery.json"},{"id":"surgeons","title":"Find cardiac surgeons and heart specialists by procedure","kind":"surgeons","url":"https://hub.bookimed.com/heart-surgery/surgeons/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/surgeons.json"},{"id":"endocarditis-surgery","title":"Endocarditis: valve infection and surgical assessment","kind":"guide","url":"https://hub.bookimed.com/heart-surgery/endocarditis-surgery/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/endocarditis-surgery.json"},{"id":"repeat-heart-surgery","title":"Repeat heart surgery: reoperation and alternative approaches","kind":"guide","url":"https://hub.bookimed.com/heart-surgery/repeat-heart-surgery/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/repeat-heart-surgery.json"},{"id":"surgeon-rankings","title":"Heart surgeon rankings by reported experience, method and results","kind":"guide","url":"https://hub.bookimed.com/heart-surgery/surgeon-rankings/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/surgeon-rankings.json"},{"id":"clinic-cleveland","title":"Cleveland Clinic: heart surgery expertise","kind":"clinic-profile","url":"https://hub.bookimed.com/heart-surgery/clinic-cleveland/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/clinic-cleveland.json"}],"entity":{"id":"shinya-unai","name":"Shinya Unai","programme_id":"cleveland","role":"Cardiac surgeon, Cleveland Clinic Main Campus","procedure_relevance":["Complex endocarditis, repeat heart surgery and valve/aortic-root reconstruction."],"source_ids":["SP13","SP21","SP22"],"official_url":"https://providers.clevelandclinic.org/provider/shinya-unai/4268207","clinical_role_type":"surgeon","topic_slugs":["endocarditis-surgery","repeat-heart-surgery"],"method_tags":["endocarditis","complex-redo","aortic-root-reconstruction"],"profile":{"intro":"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.","clinical_focus":[{"label":"Reconstruction beyond one valve","text":"His clinical profile includes endocarditis, repeat surgery, aortic/root surgery and valve repair or replacement.","source_ids":["SP13"]},{"label":"Imaging can understate invasion","text":"In a historical 644-patient native aortic endocarditis cohort, 260 had invasive disease at surgery; preoperative echo detected invasion in 43% of those cases.","source_ids":["SP21"]},{"label":"Complex abscess surgery","text":"A 154-adult mitral-abscess cohort reported that 27% required reconstruction of the aortomitral continuity with a Commando procedure.","source_ids":["SP22"]}],"evidence":[{"title":"Abscess disease needs context","summary":"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.","source_ids":["SP22"],"limitations":"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."},{"title":"Imaging may understate reconstruction needs","summary":"A separate historical surgical cohort found invasive native aortic infection could be absent from preoperative imaging findings.","source_ids":["SP21"],"limitations":"Selected patients who underwent surgery at one tertiary centre; not a rule that imaging is unnecessary or inaccurate in every case."}],"consultation_questions":[],"current_role_note":"Cardiac surgeon, Cleveland Clinic Main Campus · Cleveland, Ohio, United States.","key_takeaways":[{"label":"Reconstruction beyond one valve","text":"His clinical profile includes endocarditis, repeat surgery, aortic/root surgery and valve repair or replacement.","sources":["SP13"]},{"label":"Imaging can understate invasion","text":"In a historical 644-patient native aortic endocarditis cohort, 260 had invasive disease at surgery; preoperative echo detected invasion in 43% of those cases.","sources":["SP21"]},{"label":"Complex abscess surgery","text":"A 154-adult mitral-abscess cohort reported that 27% required reconstruction of the aortomitral continuity with a Commando procedure.","sources":["SP22"]}],"benefits":[{"text":"His endocarditis and reoperative scope includes reconstruction when infection extends beyond a valve into surrounding tissue.","sources":["SP13","SP21"]}],"limitations":[{"text":"These are high-risk historical referral cohorts, not Unai’s personal outcomes. Recent publication dates do not make the underlying 2002–2020-era patients a contemporary surgical cohort.","sources":["SP13","SP21","SP22"]}],"patient_sections":[{"id":"benefit-balance","title":"Benefits and limitations","paragraphs":[],"items":[],"sources":[],"kind":"benefit-balance","links":[],"table":null},{"id":"research","title":"Procedure-specific research","paragraphs":[],"items":[],"sources":[],"kind":"doctor-evidence","links":[],"table":null},{"id":"team","title":"Clinical programme","paragraphs":[],"items":[],"sources":[],"kind":"doctor-clinic","links":[],"table":null}]},"bookimed_route":null,"portrait":{"url":"https://hub.bookimed.com/wp-content/uploads/2026/10/shinya-unai-240x300.jpg","source_page":"https://providers.clevelandclinic.org/provider/shinya-unai/4268207","width":1200,"height":1500,"alt":"Shinya Unai, MD"},"topics":["endocarditis","redo"],"headline":"endocarditis and complex repeat surgery","profile_slug":"doctor-shinya-unai","discipline":"cardiac surgeon"},"sources":{"cleveland-programme":{"id":"cleveland-programme","title":"Mitral and Tricuspid Valve Center | Cleveland Clinic","url":"https://my.clevelandclinic.org/departments/heart/depts/mitral-and-tricuspid-valve-center","read_at":"2026-10-07","source_type":"official_hospital"},"rank-cleveland1559":{"id":"rank-cleveland1559","title":"Surgical management of LVOT obstruction in a specialized HOCM center","url":"https://doi.org/10.1016/j.jtcvs.2018.11.148","read_at":"2026-10-07","source_kind":"primary_study","body_access":"primary_abstract_read_full_text_subscription","support_location":"PubMed30782406; Methods/Results","short_excerpt":"1559 consecutive operations for left ventricular outflow tract obstruction","source_type":"primary_study"},"rank-smedira-current":{"id":"rank-smedira-current","title":"Nicholas Smedira, MD — Cleveland Clinic","url":"https://providers.clevelandclinic.org/provider/nicholas-smedira/4268212","read_at":"2026-10-07","source_kind":"official_hospital_profile","body_access":"full_page_read","support_location":"Biography; Specialty interests; Number of Procedures Performed; Locations","short_excerpt":"including 350 heart transplants and more than 2,000 septal myectomies","source_type":"official_hospital_profile"},"mitral-cleveland-robotic-learning-0":{"url":"https://pubmed.ncbi.nlm.nih.gov/28893396/","doi":"10.1016/j.jtcvs.2017.07.037","title":"Early results of robotically assisted mitral valve surgery: Analysis of the first 1000 cases","published":"2018 issue; 2017 online","access_note":"Primary abstract text acquired in web search; direct PubMed route returned a cookies challenge. Full article not inspected. Recovery via Europe PMC attempted.","id":"mitral-cleveland-robotic-learning-0","publisher":"Primary journal article","read_at":"2026-10-07","source_type":"Institutional first1000 robotic operations; primary journal abstract plus current official programme body"},"cleveland-valve-center":{"url":"https://my.clevelandclinic.org/departments/heart/depts/mitral-and-tricuspid-valve-center","title":"Mitral and Tricuspid Valve Center","publisher":"Cleveland Clinic"},"cleveland-smedira":{"url":"https://providers.clevelandclinic.org/provider/nicholas-smedira/4268212","title":"Nicholas Smedira — current clinical profile","publisher":"Cleveland Clinic"},"cleveland-robotic-current":{"url":"https://consultqd.clevelandclinic.org/robotically-assisted-mitral-valve-repair-patient-applications-grow","title":"Robotically Assisted Mitral Valve Repair: Patient Applications Grow","publisher":"Cleveland Clinic"},"cleveland-hcm1559":{"url":"https://doi.org/10.1016/j.jtcvs.2018.11.148","title":"Surgical management of left ventricular outflow tract obstruction in a specialized hypertrophic obstructive cardiomyopathy center","publisher":"Journal of Thoracic and Cardiovascular Surgery"},"cleveland-mitral1000":{"url":"https://pubmed.ncbi.nlm.nih.gov/28893396/","title":"Early results of robotically assisted mitral valve surgery: Analysis of the first 1000 cases","publisher":"Journal of Thoracic and Cardiovascular Surgery"},"ax-partner3-seven":{"id":"ax-partner3-seven","title":"Transcatheter or Surgical Aortic-Valve Replacement in Low-Risk Patients at 7 Years","url":"https://pubmed.ncbi.nlm.nih.gov/41144631/","publisher":"New England Journal of Medicine","published":"2025-10-27 online; 2026-02-19 issue","read_at":"2026-10-08","source_type":"Primary randomized trial follow-up","source_kind":"Primary randomized trial follow-up","body_access":"complete_original_abstract_read_via_Europe_PMC","support_location":"Original abstract Methods, Results and Conclusions","doi":"10.1056/NEJMoa2509766","body_file":"sources/partner3.json","access_limit":"NEJM full-text route returned 403. Complete original abstract read via Europe PMC. No device-specific leakage/pacemaker comparison extracted from an unread supplement."},"pd-adult-kapadia-official":{"title":"Samir Kapadia, MD","publisher":"Cleveland Clinic","url":"https://my.clevelandclinic.org/staff/5003-samir-kapadia","read_at":"2026-10-08","kind":"official provider or programme page","support":"Current cardiovascular medicine chair; interventional cardiologist, TAVR and complex coronary intervention expertise.","limitations":"An institutional listing supports current role and stated clinical scope; it does not establish the next appointment, operating allocation or individual risk-adjusted results.","body_file":"outputs/heart-surgery-hub-20261007/review/provider-depth/adult/sources/kapadia-official.txt"},"pd-adult-partner3":{"title":"Transcatheter or Surgical Aortic-Valve Replacement in Low-Risk Patients at 7 Years.","publisher":"The New England journal of medicine","url":"https://pubmed.ncbi.nlm.nih.gov/41144631/","read_at":"2026-10-08","kind":"original study abstract and author/affiliation record","support":"Abstract body and authorship inspected; numerical claims below are restricted to the reported endpoint and population.","limitations":"Full manuscript and supplementary operator allocations were not read in this pass. Authorship is not an individual surgical outcome series.","body_file":"outputs/heart-surgery-hub-20261007/review/provider-depth/adult/sources/partner3.json","published_at":"2025-10-27","doi":"10.1056/nejmoa2509766","authors":"Leon MB, Mack MJ, Pibarot P, Hahn RT, Thourani VH, Kodali SH, Généreux P, Kapadia SR, Cohen DJ, Pocock SJ, Zhang Y, Szerlip M, Ternacle J, Malaisrie SC, Herrmann HC, Szeto WY, Russo MJ, Babaliaros V, Nazif T, Webb JG, Makkar RR, PARTNER 3 Investigators."},"SP13":{"title":"Shinya Unai, MD — cardiac surgery profile","publisher":"Cleveland Clinic","url":"https://providers.clevelandclinic.org/provider/shinya-unai/4268207","read_at":"2026-10-08","source_kind":"official-institution","local_body":"/Users/eugen/Projects/frankenstein-agentic-framework/outputs/heart-surgery-hub-20261007/review/provider-depth/specialties/sources/unai-profile.txt","supports":"Current Main Campus surgeon, complex reoperative surgery, endocarditis, aortic/root reconstruction, transplantation and LVAD clinical interests.","limitations":"Hospital and all-surgeon volume/quality statements are not personal procedure-specific results; omitted from candidate."},"SP21":{"title":"The Hidden Burden of Native Aortic Valve Endocarditis: Reevaluating Diagnostic and Pathologic Challenges.","publisher":"The Annals of thoracic surgery","url":"https://pubmed.ncbi.nlm.nih.gov/41482022/","read_at":"2026-10-08","published_at":"2025-12-31","doi":"10.1016/j.athoracsur.2025.12.007","pmid":"41482022","source_kind":"primary-research-abstract","local_body":"/Users/eugen/Projects/frankenstein-agentic-framework/outputs/heart-surgery-hub-20261007/review/provider-depth/specialties/sources/pmid-41482022.json","supports":"Cleveland native aortic valve endocarditis cohort 2002–2020: invasive disease can escape preoperative imaging and require complex reconstruction; Unai coauthor.","limitations":"Historical referral-centre surgical cohort; not all endocarditis patients or personal results."},"SP22":{"title":"Mitral valve abscess: echocardiographic imaging, microbiology, management, and outcomes.","publisher":"European heart journal. Imaging methods and practice","url":"https://pubmed.ncbi.nlm.nih.gov/42394651/","read_at":"2026-10-08","published_at":"2026-07-02","doi":"10.1093/ehjimp/qyag112","pmid":"42394651","source_kind":"primary-research-abstract","local_body":"/Users/eugen/Projects/frankenstein-agentic-framework/outputs/heart-surgery-hub-20261007/review/provider-depth/specialties/sources/pmid-42394651.json","supports":"Cleveland mitral abscess series of 154 adults from databases spanning 2002–2020 and 2010–2020; complex reconstruction and substantial risk; Unai coauthor.","limitations":"Variable follow-up. The 71% total-follow-up mortality is not a fixed-year rate. Programme series, not Unai personal operations; published 2026 does not make cohort current."},"tp-cleveland":{"title":"Cleveland: 1,559 operations in a specialised HCM centre","url":"https://doi.org/10.1016/j.jtcvs.2018.11.148","kind":"primary clinical study; prior research edition","checked":"2026-10-08","accessed":"2026-10-08"},"pc-smedira-current":{"title":"Current official surgeon profile","url":"https://providers.clevelandclinic.org/provider/nicholas-smedira/4268212","kind":"official hospital page","checked":"2026-10-08","accessed":"2026-10-08"},"volume-hcm-nicholas-smedira-participation-over2000":{"id":"volume-hcm-nicholas-smedira-participation-over2000","title":"Dr. Nicholas Smedira, MD - Cleveland, OH - Cardiac Surgery - Request Appointment","url":"https://providers.clevelandclinic.org/provider/nicholas-smedira/4268212","publisher":"Cleveland Clinic","published":null,"read_at":"2026-10-08","source_type":"Reported clinical activity; scope shown with figure"}}}