{"schema_version":"bookimed.page-context.v1","id":"latent-obstructive-hcm","url":"https://hub.bookimed.com/heart-surgery/latent-obstructive-hcm/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/latent-obstructive-hcm.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":"guide","title":"Latent obstructive HCM: exercise gradients, SAM and surgery","summary":"HCM obstruction can emerge only during exertion. The septum, moving mitral leaflet and supporting structures can all narrow the outflow tract, so a normal-looking resting gradient does not settle the mechanism.","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":"30 and 50 mmHg mean different things","text":"A gradient of at least 30 mmHg identifies obstruction. At least 50 mmHg at rest or with provocation generally supports considering advanced treatment when symptoms persist despite appropriate care; the number alone does not require surgery.","sources":["D07"]},{"label":"Exercise imaging can reveal hidden obstruction","text":"Supervised provocation and exercise echocardiography are used when resting results do not explain symptoms.","sources":["C10"]},{"label":"SAM can cause valve leakage","text":"Mitral movement towards the outflow tract can contribute to obstruction and leakage; an independent valve lesion is a different problem.","sources":["D07"]}],"benefits":[{"text":"An anatomy-based assessment can identify when muscle removal alone is sufficient and when associated mitral or subvalvular treatment is relevant.","sources":["D07"]}],"limitations":[{"text":"Neither SAM nor septal thickness alone determines the operation. Rhythm-risk assessment and family screening remain relevant after obstruction is relieved.","sources":["C10"]}],"sections":[{"id":"benefit-balance","title":"Benefits and trade-offs","text":"Benefits and trade-offs Potential advantages An anatomy-based assessment can identify when muscle removal alone is sufficient and when associated mitral or subvalvular treatment is relevant. Sources: 2024 HCM guideline: official teaching slides Trade-offs and limits Neither SAM nor septal thickness alone determines the operation. Rhythm-risk assessment and family screening remain relevant after obstruction is relieved. Sources: AHA/ACC HCM guidance (2024)","links":[{"label":"2024 HCM guideline: official teaching slides","url":"https://professional.heart.org/-/media/PHD-Files/Education/2024_HCM_Guideline_for_the_Management_of_HCM_Slide_Deck.pdf"},{"label":"AHA/ACC HCM guidance (2024)","url":"https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2024/05/06/15/12/2024-hypertrophic-cardiomyopathy-gl"}]},{"id":"rest-exercise","title":"Why resting and exercise results can differ","text":"Why resting and exercise results can differ Dynamic left-ventricular outflow tract obstruction (LVOTO) changes with loading conditions and contraction. “Latent”, “provocable” and “exercise-induced” obstruction describe a problem that may be absent or less apparent at rest. The 2024 guideline recommends provocation when the resting gradient is below 50 mmHg; symptomatic patients without a resting or provocable gradient of at least 50 mmHg should have exercise echocardiography to look for dynamic obstruction. These are supervised clinical tests, not instructions to provoke symptoms yourself. The guideline teaching slides distinguish a gradient of at least 30 mmHg as obstruction from at least 50 mmHg as a general threshold for considering advanced treatment in patients whose symptoms persist despite standard management. A number alone is not an indication for surgery. Sources: AHA/ACC HCM guidance (2024) · 2024 HCM guideline: official teaching slides","links":[{"label":"AHA/ACC HCM guidance (2024)","url":"https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2024/05/06/15/12/2024-hypertrophic-cardiomyopathy-gl"},{"label":"2024 HCM guideline: official teaching slides","url":"https://professional.heart.org/-/media/PHD-Files/Education/2024_HCM_Guideline_for_the_Management_of_HCM_Slide_Deck.pdf"}]},{"id":"sam","title":"SAM is an anatomical clue, not a separate operation","text":"SAM is an anatomical clue, not a separate operation Systolic anterior motion (SAM) means the mitral valve moves towards the outflow tract during contraction. It can contribute to both obstruction and leakage, but SAM alone does not establish an HCM diagnosis. Leakage caused by SAM may improve after obstruction is relieved. An independent structural mitral lesion can require a separate repair. Elongated leaflets and abnormal papillary or chordal anatomy can also change the correction needed. Sources: 2024 HCM guideline: official teaching slides · AHA/ACC HCM guidance (2024)","links":[{"label":"2024 HCM guideline: official teaching slides","url":"https://professional.heart.org/-/media/PHD-Files/Education/2024_HCM_Guideline_for_the_Management_of_HCM_Slide_Deck.pdf"},{"label":"AHA/ACC HCM guidance (2024)","url":"https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2024/05/06/15/12/2024-hypertrophic-cardiomyopathy-gl"}]},{"id":"plan","title":"How anatomy changes the operation","text":"How anatomy changes the operation The same septal thickness can coexist with different mechanisms of obstruction. Imaging identifies which structures contribute. Finding Clinical meaning Obstruction only with exertion Explains why resting measurements alone may not match limiting symptoms Basal septal narrowing Can be targeted by selected muscle removal Mitral or papillary/chordal abnormalities May require additional correction rather than muscle removal alone SAM-related leakage Can improve when the obstruction mechanism is corrected Independent valve or coronary disease May change the operative scope and appropriate access Sources: 2024 HCM guideline: official teaching slides HCM & myectomy ↗","links":[{"label":"2024 HCM guideline: official teaching slides","url":"https://professional.heart.org/-/media/PHD-Files/Education/2024_HCM_Guideline_for_the_Management_of_HCM_Slide_Deck.pdf"},{"label":"HCM & myectomy ↗","url":"https://hub.bookimed.com/heart-surgery/hcm-myectomy/"}],"tables":[[["Finding","Clinical meaning"],["Obstruction only with exertion","Explains why resting measurements alone may not match limiting symptoms"],["Basal septal narrowing","Can be targeted by selected muscle removal"],["Mitral or papillary/chordal abnormalities","May require additional correction rather than muscle removal alone"],["SAM-related leakage","Can improve when the obstruction mechanism is corrected"],["Independent valve or coronary disease","May change the operative scope and appropriate access"]]]},{"id":"choices","title":"Where medicines and septal reduction fit","text":"Where medicines and septal reduction fit Persistent symptoms despite appropriate initial treatment can lead to consideration of further drug therapy or septal reduction. Surgical myectomy is particularly relevant when another cardiac abnormality also needs surgery. Experienced HCM centres should assess these alternatives with you. An axillary incision, sternotomy or newer beating-heart approach describes how treatment is delivered. First establish what the operation must correct. The published comparisons below separate access, associated procedures and follow-up. Sources: AHA/ACC HCM guidance (2024) Compare surgeon expertise ↗ Minimally invasive ↗ Nonobstructive & apical HCM ↗","links":[{"label":"AHA/ACC HCM guidance (2024)","url":"https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2024/05/06/15/12/2024-hypertrophic-cardiomyopathy-gl"},{"label":"Compare surgeon expertise ↗","url":"https://hub.bookimed.com/heart-surgery/septal-myectomy-surgeon-comparison/"},{"label":"Minimally invasive ↗","url":"https://hub.bookimed.com/heart-surgery/minimally-invasive/"},{"label":"Nonobstructive & apical HCM ↗","url":"https://hub.bookimed.com/heart-surgery/nonobstructive-apical-hcm/"}]},{"id":"records","title":"How improvement is assessed","text":"How improvement is assessed After treatment, follow-up measures the remaining gradient, mitral leakage and symptoms. Pacemaker requirement and other complications are separate outcomes; a favourable scan alone does not describe the whole recovery. Sources: AHA/ACC HCM guidance (2024) · 2024 HCM guideline: official teaching slides","links":[{"label":"AHA/ACC HCM guidance (2024)","url":"https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2024/05/06/15/12/2024-hypertrophic-cardiomyopathy-gl"},{"label":"2024 HCM guideline: official teaching slides","url":"https://professional.heart.org/-/media/PHD-Files/Education/2024_HCM_Guideline_for_the_Management_of_HCM_Slide_Deck.pdf"}]},{"id":"after","title":"Care continues after relief of obstruction","text":"Care continues after relief of obstruction Myectomy addresses obstruction; ongoing HCM follow-up, rhythm and sudden-death risk assessment and family evaluation remain separate parts of care. Sources: AHA/ACC HCM guidance (2024) Recovery ↗","links":[{"label":"AHA/ACC HCM guidance (2024)","url":"https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2024/05/06/15/12/2024-hypertrophic-cardiomyopathy-gl"},{"label":"Recovery ↗","url":"https://hub.bookimed.com/heart-surgery/recovery/"}]},{"id":"matching-specialists","title":"Specialists for this treatment pathway","text":"Specialists for this treatment pathway Explore each specialist’s clinical focus, current programme and the studies relevant to this treatment. The listed roles include cardiac surgeons and, where appropriate, interventional cardiologists. Portrait source ↗ Monza · Italy cardiac surgeon Paolo Ferrazzi → Ferrazzi’s HCM work combines septal myectomy with selective cutting of abnormal secondary mitral chordae. Monza research affiliation documented in 2026; the scientific-director appointment source is dated 2023. Policlinico di Monza → Sources: Ferrazzi et al. · JACC 2026 · 350 patients · Policlinico di Monza · heart centre brochure (2023) View expertise and research → Portrait source ↗ Hangzhou · China cardiac surgeon Yong Cui → Cui’s team has published infra-axillary transaortic myectomy and a separate newer MESM technique for obstructive HCM. Zhejiang Provincial People’s Hospital → Sources: An innovative minimally invasive approach for HOCM: transaortic septal myectomy via right infra-axillary incision · Minimally Invasive Electro Septal Myectomy for HOCM Through a Right Infra-Axillary Incision View expertise and research → Portrait source ↗ New York · United States cardiac surgeon Daniel G. Swistel → Swistel’s resect–plicate–release work addresses septal muscle, selected elongated mitral leaflets and abnormal papillary attachments. NYU Langone → Sources: Resect–plicate–release · 77-patient study (2015) · NYU Langone · Daniel Swistel · NYU Langone · HCM programme View expertise and research → JD Rochester, Minnesota · United States cardiac surgeon Joseph A. Dearani → Dearani’s Mayo practice includes septal myectomy and complex HCM anatomy. The programme also evaluates selected apical disease and associated apical aneurysms. Mayo Clinic Rochester → Sources: Mayo Clinic · Joseph Dearani · Mayo Clinic · HCM treatment options · Mayo · 67 patients with apical aneurysm repair View expertise and research → XW Wuhan · China cardiac surgeon Xiang Wei → Wei’s Tongji team developed transapical beating-heart septal myectomy. The studied technique reaches the septum through the heart’s apex without cardiopulmonary bypass. Tongji Hospital Wuhan → Sources: Tongji Hospital · cardiovascular surgery department · TA-BSM for obstructive HCM: Lessons Learned After the Learning Curve Period View expertise and research → Portrait source ↗ Cleveland, Ohio · United States cardiac surgeon Nicholas Smedira → Smedira’s Cleveland Clinic practice includes myectomy for HCM. The programme also treats selected mitral and subvalvular abnormalities that contribute to obstruction. Cleveland Clinic → Sources: Nicholas Smedira, MD — Cleveland Clinic · Surgical management of LVOT obstruction in a specialized HOCM center View expertise and research → Browse the full specialist directory →","links":[{"label":"Portrait source ↗","url":"https://www.policlinicodimonza.it/wp-content/uploads/2024/04/BROCHURE-CENTRO-CUORE-MONZA_marzo23_WEB.pdf#page=4"},{"label":"Paolo Ferrazzi →","url":"https://hub.bookimed.com/heart-surgery/doctor-paolo-ferrazzi/"},{"label":"Policlinico di Monza →","url":"https://hub.bookimed.com/heart-surgery/clinic-policlinico-monza/"},{"label":"Ferrazzi et al. · JACC 2026 · 350 patients","url":"https://pubmed.ncbi.nlm.nih.gov/42307496/"},{"label":"Policlinico di Monza · heart centre brochure (2023)","url":"https://www.policlinicodimonza.it/wp-content/uploads/2024/04/BROCHURE-CENTRO-CUORE-MONZA_marzo23_WEB.pdf"},{"label":"View expertise and research →","url":"https://hub.bookimed.com/heart-surgery/doctor-paolo-ferrazzi/"},{"label":"Portrait source ↗","url":"https://dryongcuiheartsurgery.com/"},{"label":"Yong Cui →","url":"https://hub.bookimed.com/heart-surgery/doctor-yong-cui/"},{"label":"Zhejiang Provincial People’s Hospital →","url":"https://hub.bookimed.com/heart-surgery/clinic-zhejiang/"},{"label":"An innovative minimally invasive approach for HOCM: transaortic septal myectomy via right infra-axillary incision","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC11632347/"},{"label":"Minimally Invasive Electro Septal Myectomy for HOCM Through a Right Infra-Axillary Incision","url":"https://doi.org/10.1016/j.athoracsur.2025.09.023"},{"label":"View expertise and research →","url":"https://hub.bookimed.com/heart-surgery/doctor-yong-cui/"},{"label":"Portrait source ↗","url":"https://nyulangone.org/doctors/1083603690/daniel-g-swistel"},{"label":"Daniel G. Swistel →","url":"https://hub.bookimed.com/heart-surgery/doctor-daniel-swistel/"},{"label":"NYU Langone →","url":"https://hub.bookimed.com/heart-surgery/clinic-nyu-langone/"},{"label":"Resect–plicate–release · 77-patient study (2015)","url":"https://pubmed.ncbi.nlm.nih.gov/26272699/"},{"label":"NYU Langone · Daniel Swistel","url":"https://nyulangone.org/doctors/1083603690/daniel-g-swistel"},{"label":"NYU Langone · HCM programme","url":"https://nyulangone.org/care-services/hypertrophic-cardiomyopathy-program"},{"label":"View expertise and research →","url":"https://hub.bookimed.com/heart-surgery/doctor-daniel-swistel/"},{"label":"Joseph A. Dearani →","url":"https://hub.bookimed.com/heart-surgery/doctor-joseph-dearani/"},{"label":"Mayo Clinic Rochester →","url":"https://hub.bookimed.com/heart-surgery/clinic-mayo-rochester/"},{"label":"Mayo Clinic · Joseph Dearani","url":"https://www.mayoclinic.org/biographies/dearani-joseph-a-m-d/bio-20053326"},{"label":"Mayo Clinic · HCM treatment options","url":"https://www.mayoclinic.org/diseases-conditions/hypertrophic-cardiomyopathy/diagnosis-treatment/drc-20350204"},{"label":"Mayo · 67 patients with apical aneurysm repair","url":"https://pubmed.ncbi.nlm.nih.gov/37029070/"},{"label":"View expertise and research →","url":"https://hub.bookimed.com/heart-surgery/doctor-joseph-dearani/"},{"label":"Xiang Wei →","url":"https://hub.bookimed.com/heart-surgery/doctor-xiang-wei/"},{"label":"Tongji Hospital Wuhan →","url":"https://hub.bookimed.com/heart-surgery/clinic-tongji-wuhan/"},{"label":"Tongji Hospital · cardiovascular surgery department","url":"https://www.tjh.com.cn/channels/1008.html"},{"label":"TA-BSM for obstructive HCM: Lessons Learned After the Learning Curve Period","url":"https://doi.org/10.1161/CIRCINTERVENTIONS.124.015044"},{"label":"View expertise and research →","url":"https://hub.bookimed.com/heart-surgery/doctor-xiang-wei/"},{"label":"Portrait source ↗","url":"https://providers.clevelandclinic.org/provider/nicholas-smedira/4268212"},{"label":"Nicholas Smedira →","url":"https://hub.bookimed.com/heart-surgery/doctor-nicholas-smedira/"},{"label":"Cleveland Clinic →","url":"https://hub.bookimed.com/heart-surgery/clinic-cleveland/"},{"label":"Nicholas Smedira, MD — Cleveland Clinic","url":"https://providers.clevelandclinic.org/provider/nicholas-smedira/4268212"},{"label":"Surgical management of LVOT obstruction in a specialized HOCM center","url":"https://doi.org/10.1016/j.jtcvs.2018.11.148"},{"label":"View expertise and research →","url":"https://hub.bookimed.com/heart-surgery/doctor-nicholas-smedira/"},{"label":"Browse the full specialist directory →","url":"https://hub.bookimed.com/heart-surgery/septal-myectomy-surgeons/"}]},{"id":"treatment-programmes","title":"Compare complete treatment programmes","text":"Compare complete treatment programmes Hangzhou, China Yong Cui · HCM surgery ↗ Yong Cui Zhejiang Provincial People’s Hospital A 4–5 cm underarm incision keeps the breastbone intact: no divided breastbone to heal while you rebuild walking and everyday activity. $25,000–40,000 estimated cost USD · estimated programme range · updated 8 October 2026. Published 100-patient MESM series; separate 132-patient mid-cavity conference report and earlier 148-patient modified-Morrow study. See method, care and package ↗ Cleveland, United States Nicholas Smedira · complex HCM surgery ↗ 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. See method, care and package ↗ New York, United States NYU HCM team · anatomy and access choices ↗ Daniel Swistel · Joshua Scheinerman NYU Langone Hypertrophic Cardiomyopathy Program An HCM team that treats septal and mitral causes of obstruction, with conventional and selected robotic surgical approaches. Quote on request Individual estimate after assessment. NYU reports more than 600 myectomies at programme level. Supporting method evidence includes a historical 77-patient anatomy study and a separate first robotic case report. See method, care and package ↗ Treatment programmes ↗","links":[{"label":"Yong Cui · HCM surgery ↗","url":"https://hub.bookimed.com/heart-surgery/programme-cui-hcm/"},{"label":"See method, care and package ↗","url":"https://hub.bookimed.com/heart-surgery/programme-cui-hcm/"},{"label":"Nicholas Smedira · complex HCM surgery ↗","url":"https://hub.bookimed.com/heart-surgery/programme-cleveland-hcm/"},{"label":"See method, care and package ↗","url":"https://hub.bookimed.com/heart-surgery/programme-cleveland-hcm/"},{"label":"NYU HCM team · anatomy and access choices ↗","url":"https://hub.bookimed.com/heart-surgery/programme-nyu-hcm/"},{"label":"See method, care and package ↗","url":"https://hub.bookimed.com/heart-surgery/programme-nyu-hcm/"},{"label":"Treatment programmes ↗","url":"https://hub.bookimed.com/heart-surgery/treatment-programmes/"}]}],"introduction":"Heart surgery guide / Latent obstruction & SAM Latent obstruction & SAM · Decision guide Latent obstructive HCM: exercise gradients, SAM and surgery Obstruction can appear during exertion even when the resting scan shows a low gradient. Exercise testing and mitral anatomy can change the treatment pathway. Research by Yevhenii Kozlov · Co-Founder of Bookimed Updated 8 October 2026 Sources linked throughout At a glance HCM obstruction can emerge only during exertion. The septum, moving mitral leaflet and supporting structures can all narrow the outflow tract, so a normal-looking resting gradient does not settle the mechanism. 30 and 50 mmHg mean different things A gradient of at least 30 mmHg identifies obstruction. At least 50 mmHg at rest or with provocation generally supports considering advanced treatment when symptoms persist despite appropriate care; the number alone does not require surgery. Sources: 2024 HCM guideline: official teaching slides Exercise imaging can reveal hidden obstruction Supervised provocation and exercise echocardiography are used when resting results do not explain symptoms. Sources: AHA/ACC HCM guidance (2024) SAM can cause valve leakage Mitral movement towards the outflow tract can contribute to obstruction and leakage; an independent valve lesion is a different problem. Sources: 2024 HCM guideline: official teaching slides","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":"minimally-invasive","title":"Minimally invasive and robotic heart surgery","kind":"guide","url":"https://hub.bookimed.com/heart-surgery/minimally-invasive/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/minimally-invasive.json"},{"id":"hcm-myectomy","title":"Septal myectomy for obstructive HCM: compare treatment options","kind":"guide","url":"https://hub.bookimed.com/heart-surgery/hcm-myectomy/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/hcm-myectomy.json"},{"id":"recovery","title":"Recovery after heart surgery: hospital, home and travel","kind":"guide","url":"https://hub.bookimed.com/heart-surgery/recovery/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/recovery.json"},{"id":"second-opinion","title":"Prepare for a heart surgery second opinion","kind":"inquiry","url":"https://hub.bookimed.com/heart-surgery/second-opinion/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/second-opinion.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":"nonobstructive-apical-hcm","title":"Nonobstructive and apical HCM: treatment decisions","kind":"guide","url":"https://hub.bookimed.com/heart-surgery/nonobstructive-apical-hcm/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/nonobstructive-apical-hcm.json"},{"id":"doctor-yong-cui","title":"Yong Cui: septal myectomy and minimally invasive HCM surgery","kind":"doctor-profile","url":"https://hub.bookimed.com/heart-surgery/doctor-yong-cui/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/doctor-yong-cui.json"},{"id":"doctor-nicholas-smedira","title":"Nicholas Smedira: septal myectomy at Cleveland Clinic","kind":"doctor-profile","url":"https://hub.bookimed.com/heart-surgery/doctor-nicholas-smedira/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/doctor-nicholas-smedira.json"},{"id":"doctor-paolo-ferrazzi","title":"Paolo Ferrazzi: HCM myectomy and mitral chordal cutting","kind":"doctor-profile","url":"https://hub.bookimed.com/heart-surgery/doctor-paolo-ferrazzi/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/doctor-paolo-ferrazzi.json"},{"id":"doctor-daniel-swistel","title":"Daniel G. Swistel: HCM myectomy and mitral valve repair","kind":"doctor-profile","url":"https://hub.bookimed.com/heart-surgery/doctor-daniel-swistel/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/doctor-daniel-swistel.json"},{"id":"doctor-joseph-dearani","title":"Joseph A. Dearani: HCM and congenital heart surgery","kind":"doctor-profile","url":"https://hub.bookimed.com/heart-surgery/doctor-joseph-dearani/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/doctor-joseph-dearani.json"},{"id":"doctor-xiang-wei","title":"Xiang Wei: transapical beating-heart septal myectomy","kind":"doctor-profile","url":"https://hub.bookimed.com/heart-surgery/doctor-xiang-wei/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/doctor-xiang-wei.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"},{"id":"clinic-zhejiang","title":"Zhejiang Provincial People’s Hospital: heart surgery 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