{"schema_version":"bookimed.page-context.v1","id":"programme-cleveland-hcm","url":"https://hub.bookimed.com/heart-surgery/programme-cleveland-hcm/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/programme-cleveland-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":"treatment-programme","title":"Nicholas Smedira at Cleveland Clinic: HCM myectomy, care and cost","summary":"Nicholas Smedira is a current myectomy surgeon at Cleveland Clinic’s specialist HCM centre. The programme combines detailed imaging, anatomy-directed surgery and continuing HCM care. Its published surgical experience includes operations that correct the mitral valve and supporting structures as well as the septum. Price is individualized.","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":"More than muscle removal","text":"The plan can address an elongated mitral leaflet or abnormal papillary muscles when these contribute to obstruction.","sources":["pc-cleveland1559","pc-cleveland-podcast"]},{"label":"A defined assessment pathway","text":"A diagnostic visit without scheduled treatment generally involves 1–2 days in Cleveland, depending on testing.","sources":["pc-cleveland-pathway"]},{"label":"Historical surgical evidence","text":"The published series included 1,559 LVOT operations in 2005–2015, of which 1,530 involved myectomy.","sources":["pc-cleveland1559"]}],"benefits":[{"text":"Specialist cardiology and imaging connect symptoms, dynamic obstruction and valve anatomy to a surgical plan.","sources":["pc-cleveland-pathway","pc-cleveland-podcast"]},{"text":"Myectomy can be combined with mitral or subvalvular correction during the same operation when anatomy requires it.","sources":["pc-cleveland1559"]},{"text":"An established pathway links diagnostic assessment, surgery and continuing HCM follow-up.","sources":["pc-cleveland-pathway"]}],"limitations":[{"text":"The standard patient pathway describes sternotomy and cardiopulmonary bypass, so breastbone healing is part of recovery.","sources":["pc-cleveland-myectomy"]},{"text":"Historical centre results are not a current personal risk estimate or a direct comparison with another surgeon.","sources":["pc-cleveland1559"]},{"text":"Successful relief of obstruction does not remove the need for rhythm surveillance and wider HCM care.","sources":["pc-hcm-guideline"]}],"sections":[{"id":"clinical-fit","title":"Who this programme may suit","text":"Who this programme may suit Symptomatic obstructive HCM despite appropriate medical treatment, including patients whose mitral leaflets or papillary muscles contribute to restricted outflow. These anatomical findings can make surgery more comprehensive than isolated septal reduction. The visit includes clinical intake, HCM cardiology and specialist echocardiography; MRI, CT or other tests add information when clinically indicated. Imaging distinguishes septal obstruction from mitral-leaflet and papillary-muscle contributions. Treatment history and overall risk determine whether surgery, medication or another septal-reduction option fits. Sources: HCM Center appointment and care pathway · Desai and Smedira: diagnostic and surgical decision-making · 2024 AHA/ACC multisociety HCM guideline key points","links":[{"label":"HCM Center appointment and care pathway","url":"https://my.clevelandclinic.org/departments/heart/depts/hypertrophic-cardiomyopathy"},{"label":"Desai and Smedira: diagnostic and surgical decision-making","url":"https://my.clevelandclinic.org/podcasts/cardiac-consult/surgical-myectomy-for-hypertrophic-cardiomyopathy"},{"label":"2024 AHA/ACC multisociety HCM guideline key points","url":"https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2024/05/06/15/12/2024-hypertrophic-cardiomyopathy-gl"}]},{"id":"benefit-balance","title":"Benefits and trade-offs","text":"Benefits and trade-offs Potential advantages Specialist cardiology and imaging connect symptoms, dynamic obstruction and valve anatomy to a surgical plan. Sources: HCM Center appointment and care pathway · Desai and Smedira: diagnostic and surgical decision-making Myectomy can be combined with mitral or subvalvular correction during the same operation when anatomy requires it. Sources: Surgical management of left ventricular outflow tract obstruction in a specialized hypertrophic obstructive cardiomyopathy center. An established pathway links diagnostic assessment, surgery and continuing HCM follow-up. Sources: HCM Center appointment and care pathway Trade-offs and limits The standard patient pathway describes sternotomy and cardiopulmonary bypass, so breastbone healing is part of recovery. Sources: Septal myectomy patient information Historical centre results are not a current personal risk estimate or a direct comparison with another surgeon. Sources: Surgical management of left ventricular outflow tract obstruction in a specialized hypertrophic obstructive cardiomyopathy center. Successful relief of obstruction does not remove the need for rhythm surveillance and wider HCM care. Sources: 2024 AHA/ACC multisociety HCM guideline key points","links":[{"label":"HCM Center appointment and care pathway","url":"https://my.clevelandclinic.org/departments/heart/depts/hypertrophic-cardiomyopathy"},{"label":"Desai and Smedira: diagnostic and surgical decision-making","url":"https://my.clevelandclinic.org/podcasts/cardiac-consult/surgical-myectomy-for-hypertrophic-cardiomyopathy"},{"label":"Surgical management of left ventricular outflow tract obstruction in a specialized hypertrophic obstructive cardiomyopathy center.","url":"https://pubmed.ncbi.nlm.nih.gov/30782406/"},{"label":"HCM Center appointment and care pathway","url":"https://my.clevelandclinic.org/departments/heart/depts/hypertrophic-cardiomyopathy"},{"label":"Septal myectomy patient information","url":"https://my.clevelandclinic.org/health/treatments/17461-septal-myectomy"},{"label":"Surgical management of left ventricular outflow tract obstruction in a specialized hypertrophic obstructive cardiomyopathy center.","url":"https://pubmed.ncbi.nlm.nih.gov/30782406/"},{"label":"2024 AHA/ACC multisociety HCM guideline key points","url":"https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2024/05/06/15/12/2024-hypertrophic-cardiomyopathy-gl"}]},{"id":"programme-price","title":"Price and included care","text":"Price and included care Quote on request Pricing follows the proposed operation and required care. The inspected programme sources publish no standard package total or hotel, interpreter and companion allowance. The centre describes HCM cardiology, specialist imaging, surgical assessment, inpatient recovery and individualized follow-up. Virtual follow-up is an available option. No standard international package price is published. Care / cost item Published care and cost scope Assessment HCM cardiology and specialist imaging are described. A diagnostic visit without treatment generally takes 1–2 days locally; the testing plan determines the duration. Surgery Septal myectomy with mitral or papillary correction when required. There is no published standard cash package for a fixed operative scope. Hospital care Anaesthesia, ICU monitoring and ward recovery form the pathway. Charges and allowances are individualized. Follow-up Follow-up is individualized, with a virtual option. Rehabilitation and further imaging depend on recovery and clinical findings. Travel services The clinical sources do not define included hotel nights, transfers, interpreter services or companion costs.","links":[],"tables":[[["Care / cost item","Published care and cost scope"],["Assessment","HCM cardiology and specialist imaging are described. A diagnostic visit without treatment generally takes 1–2 days locally; the testing plan determines the duration."],["Surgery","Septal myectomy with mitral or papillary correction when required. There is no published standard cash package for a fixed operative scope."],["Hospital care","Anaesthesia, ICU monitoring and ward recovery form the pathway. Charges and allowances are individualized."],["Follow-up","Follow-up is individualized, with a virtual option. Rehabilitation and further imaging depend on recovery and clinical findings."],["Travel services","The clinical sources do not define included hotel nights, transfers, interpreter services or companion costs."]]]},{"id":"care-journey","title":"Your route from assessment to follow-up","text":"Your route from assessment to follow-up Record and imaging review The centre reviews the medical history and original imaging before or as part of the diagnostic visit. Sources: HCM Center appointment and care pathway Specialist assessment HCM cardiology and imaging establish the obstruction and treatment options. Diagnostic assessment alone typically requires 1–2 days locally. Sources: HCM Center appointment and care pathway Myectomy and any associated correction The operation removes obstructing septal muscle and addresses relevant mitral or papillary abnormalities. Sources: Surgical management of left ventricular outflow tract obstruction in a specialized hypertrophic obstructive cardiomyopathy center. Recovery and follow-up ICU and ward monitoring lead to discharge and continuing HCM care. Virtual follow-up can be available. Sources: Septal myectomy patient information · HCM Center appointment and care pathway","links":[{"label":"HCM Center appointment and care pathway","url":"https://my.clevelandclinic.org/departments/heart/depts/hypertrophic-cardiomyopathy"},{"label":"HCM Center appointment and care pathway","url":"https://my.clevelandclinic.org/departments/heart/depts/hypertrophic-cardiomyopathy"},{"label":"Surgical management of left ventricular outflow tract obstruction in a specialized hypertrophic obstructive cardiomyopathy center.","url":"https://pubmed.ncbi.nlm.nih.gov/30782406/"},{"label":"Septal myectomy patient information","url":"https://my.clevelandclinic.org/health/treatments/17461-septal-myectomy"},{"label":"HCM Center appointment and care pathway","url":"https://my.clevelandclinic.org/departments/heart/depts/hypertrophic-cardiomyopathy"}]},{"id":"evidence","title":"What the research tells you","text":"What the research tells you Anatomy-directed surgery in 1,559 operations The 2005–2015 series included 1,530 operations with myectomy. In 522, myectomy was combined with mitral or subvalvular intervention. Reported operative mortality was 0.38%. Historical selected centre population; the abstract does not name its single operator. These are not a stated personal outcome rate for Smedira or a direct comparison with Cui. Sources: Surgical management of left ventricular outflow tract obstruction in a specialized hypertrophic obstructive cardiomyopathy center.","links":[{"label":"Surgical management of left ventricular outflow tract obstruction in a specialized hypertrophic obstructive cardiomyopathy center.","url":"https://pubmed.ncbi.nlm.nih.gov/30782406/"}]},{"id":"recovery","title":"Recovery: walking, healing and returning home","text":"Recovery: walking, healing and returning home Cleveland Clinic’s myectomy information describes ICU care immediately after surgery, assisted walking after about 48 hours and fewer than five inpatient days for most patients. The standard operation divides the breastbone. Discharge does not mark complete chest healing or readiness for international travel; activity restrictions depend on the operation and recovery. Sources: Septal myectomy patient information · Liverpool Heart and Chest Hospital: recovery guide Recovery ↗ HCM & myectomy ↗","links":[{"label":"Septal myectomy patient information","url":"https://my.clevelandclinic.org/health/treatments/17461-septal-myectomy"},{"label":"Liverpool Heart and Chest Hospital: recovery guide","url":"https://www.lhch.nhs.uk/adult-heart-surgery---frequently-asked-questions"},{"label":"Recovery ↗","url":"https://hub.bookimed.com/heart-surgery/recovery/"},{"label":"HCM & myectomy ↗","url":"https://hub.bookimed.com/heart-surgery/hcm-myectomy/"}]},{"id":"alternatives","title":"Compare other programmes for this condition","text":"Compare other programmes for this condition 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 ↗ 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 ↗","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":"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/"}]}],"introduction":"Heart surgery guide / Nicholas Smedira · complex HCM surgery Nicholas Smedira · complex HCM surgery · Decision guide Nicholas Smedira at Cleveland Clinic: HCM myectomy, care and cost Specialist HCM imaging and myectomy that can also correct mitral-leaflet or papillary-muscle causes of obstruction. Research by Yevhenii Kozlov · Co-Founder of Bookimed Updated 8 October 2026 Sources linked throughout At a glance Nicholas Smedira is a current myectomy surgeon at Cleveland Clinic’s specialist HCM centre. The programme combines detailed imaging, anatomy-directed surgery and continuing HCM care. Its published surgical experience includes operations that correct the mitral valve and supporting structures as well as the septum. Price is individualized. More than muscle removal The plan can address an elongated mitral leaflet or abnormal papillary muscles when these contribute to obstruction. Sources: Surgical management of left ventricular outflow tract obstruction in a specialized hypertrophic obstructive cardiomyopathy center. · Desai and Smedira: diagnostic and surgical decision-making A defined assessment pathway A diagnostic visit without scheduled treatment generally involves 1–2 days in Cleveland, depending on testing. Sources: HCM Center appointment and care pathway Historical surgical evidence The published series included 1,559 LVOT operations in 2005–2015, of which 1,530 involved myectomy. Sources: Surgical management of left ventricular outflow tract obstruction in a specialized hypertrophic obstructive cardiomyopathy center. Reported surgical experience 201 septal myectomies 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 2026-10-08 2,000+ septal myectomies Personal 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 2026-10-08 3,500+ septal myectomies Programme 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 2026-10-08 Compare septal myectomy experience → Miller Family Pavilion at Cleveland Clinic’s main campus, home to the Heart, Vascular & Thoracic Institute. · Photo source Nicholas Smedira → Cleveland Clinic HCM Center Cleveland, United States Primarily transaortic septal myectomy, with mitral or subvalvular correction when the anatomy calls for it Quote on request Individual estimate after assessment. Cleveland Clinic lists Nicholas Smedira as a myectomy surgeon in its specialist HCM centre.","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":"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":"cost","title":"Heart surgery costs: valve surgery and CABG quotes","kind":"guide","url":"https://hub.bookimed.com/heart-surgery/cost/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/cost.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":"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":"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":"septal-myectomy-surgeon-comparison","title":"HCM and septal myectomy surgeon rankings: experience, methods and results","kind":"evidence-directory","url":"https://hub.bookimed.com/heart-surgery/septal-myectomy-surgeon-comparison/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/septal-myectomy-surgeon-comparison.json"},{"id":"hcm-treatment-programmes","title":"HCM surgery programmes: compare surgeons, methods and costs","kind":"treatment-listing","url":"https://hub.bookimed.com/heart-surgery/hcm-treatment-programmes/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/hcm-treatment-programmes.json"},{"id":"programme-cui-hcm","title":"HCM surgery with Yong Cui: breastbone-sparing, $25,000–40,000","kind":"treatment-programme","url":"https://hub.bookimed.com/heart-surgery/programme-cui-hcm/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/programme-cui-hcm.json"},{"id":"programme-nyu-hcm","title":"NYU HCM surgery: mitral-preserving and robotic myectomy programmes","kind":"treatment-programme","url":"https://hub.bookimed.com/heart-surgery/programme-nyu-hcm/","json_url":"https://hub.bookimed.com/wp-content/uploads/heart-surgery-hub-20261007/pages/programme-nyu-hcm.json"}],"entity":{"condition":"Obstructive hypertrophic cardiomyopathy","condition_id":"hcm-obstructive","price":null,"currency":null,"price_label":"Quote on request","commercial_status":"Clinical programme researched; itemized patient quote not obtained","id":"cleveland-hcm","doctor_id":"nicholas-smedira","doctor":"Nicholas Smedira","clinic_id":"cleveland","clinic":"Cleveland Clinic HCM Center","location":"Cleveland, United States","title":"Nicholas Smedira at Cleveland Clinic: HCM myectomy, care and cost","card_benefit":"Specialist HCM imaging and myectomy that can also correct mitral-leaflet or papillary-muscle causes of obstruction.","method":"Primarily transaortic septal myectomy, with mitral or subvalvular correction when the anatomy calls for it","evidence":"A historical series of 1,559 LVOT operations, including 1,530 myectomies and 522 myectomies with mitral or subvalvular intervention.","recovery":"Cleveland Clinic’s myectomy information describes ICU care immediately after surgery, assisted walking after about 48 hours and fewer than five inpatient days for most patients. The standard operation divides the breastbone. Discharge does not mark complete chest healing or readiness for international travel; activity restrictions depend on the operation and recovery.","care_summary":"The centre describes HCM cardiology, specialist imaging, surgical assessment, inpatient recovery and individualized follow-up. Virtual follow-up is an available option. No standard international package price is published.","cta":"Request an HCM assessment and quote","official_entrypoint":"https://my.clevelandclinic.org/departments/heart/depts/hypertrophic-cardiomyopathy","focus":["mitral","diagnostics","followup"],"evidence_source":"pc-cleveland1559","clinical_fit":"Symptomatic obstructive HCM despite appropriate medical treatment, including patients whose mitral leaflets or papillary muscles contribute to restricted outflow. These anatomical findings can make surgery more comprehensive than isolated septal reduction.","photo":{"source_page":"https://my.clevelandclinic.org/mobile-apps/diet","width":2000,"height":1333,"alt":"Miller Family Pavilion and autumn trees at Cleveland Clinic’s main campus.","caption":"Miller Family Pavilion at Cleveland Clinic’s main campus, home to the Heart, Vascular & Thoracic Institute.","url":"https://hub.bookimed.com/wp-content/uploads/2026/10/cleveland-1024x682.jpg"},"portrait":{"url":"https://hub.bookimed.com/wp-content/uploads/2026/10/nicholas-smedira-240x300.jpg","source_page":"https://providers.clevelandclinic.org/provider/nicholas-smedira/4268212","width":1200,"height":1500,"alt":"Nicholas Smedira — official portrait"},"doctor_profile":"/heart-surgery/doctor-nicholas-smedira/","clinic_profile":"/heart-surgery/clinic-cleveland/","preference":"Nicholas Smedira — Cleveland Clinic HCM Center — HCM programme","topic":"HCM / septal myectomy","slug":"programme-cleveland-hcm","topic_key":"hcm","listing_slug":"hcm-treatment-programmes","label":"Nicholas Smedira · complex HCM surgery","link":"/heart-surgery/programme-cleveland-hcm/","clinical_sources":["pc-cleveland-pathway","pc-cleveland-podcast","pc-hcm-guideline"],"benefit_sources":["pc-cleveland-pathway","pc-cleveland-podcast","pc-cleveland1559"],"price_kind":"quote","price_note_short":"Individual estimate after assessment.","price_note":"Pricing follows the proposed operation and required care. The inspected programme sources publish no standard package total or hotel, interpreter and companion allowance.","assessment":["The visit includes clinical intake, HCM cardiology and specialist echocardiography; MRI, CT or other tests add information when clinically indicated.","Imaging distinguishes septal obstruction from mitral-leaflet and papillary-muscle contributions. Treatment history and overall risk determine whether surgery, medication or another septal-reduction option fits."],"package_rows":[["Assessment","HCM cardiology and specialist imaging are described. A diagnostic visit without treatment generally takes 1–2 days locally; the testing plan determines the duration."],["Surgery","Septal myectomy with mitral or papillary correction when required. There is no published standard cash package for a fixed operative scope."],["Hospital care","Anaesthesia, ICU monitoring and ward recovery form the pathway. Charges and allowances are individualized."],["Follow-up","Follow-up is individualized, with a virtual option. Rehabilitation and further imaging depend on recovery and clinical findings."],["Travel services","The clinical sources do not define included hotel nights, transfers, interpreter services or companion costs."]],"journey":[{"title":"Record and imaging review","text":"The centre reviews the medical history and original imaging before or as part of the diagnostic visit.","sources":["pc-cleveland-pathway"]},{"title":"Specialist assessment","text":"HCM cardiology and imaging establish the obstruction and treatment options. Diagnostic assessment alone typically requires 1–2 days locally.","sources":["pc-cleveland-pathway"]},{"title":"Myectomy and any associated correction","text":"The operation removes obstructing septal muscle and addresses relevant mitral or papillary abnormalities.","sources":["pc-cleveland1559"]},{"title":"Recovery and follow-up","text":"ICU and ward monitoring lead to discharge and continuing HCM care. Virtual follow-up can be available.","sources":["pc-cleveland-myectomy","pc-cleveland-pathway"]}],"reviews":[],"review_intro":"Patient accounts describe the experience of care. General hospital feedback does not establish the results of myectomy or a named surgeon’s performance.","recovery_sources":["pc-cleveland-myectomy","tp-recovery-lhch"],"faq":[],"doctor_ids":["nicholas-smedira"],"seo_title":"Nicholas Smedira at Cleveland Clinic: HCM myectomy, care and cost | Bookimed","summary":"Nicholas Smedira is a current myectomy surgeon at Cleveland Clinic’s specialist HCM centre. The programme combines detailed imaging, anatomy-directed surgery and continuing HCM care. Its published surgical experience includes operations that correct the mitral valve and supporting structures as well as the septum. Price is individualized.","benefits":["Specialist cardiology and imaging connect symptoms, dynamic obstruction and valve anatomy to a surgical plan.","Myectomy can be combined with mitral or subvalvular correction during the same operation when anatomy requires it.","An established pathway links diagnostic assessment, surgery and continuing HCM follow-up."],"operator_assignment":"Cleveland Clinic lists Nicholas Smedira as a myectomy surgeon in its specialist HCM centre.","evidence_blocks":[{"title":"Anatomy-directed surgery in 1,559 operations","text":"The 2005–2015 series included 1,530 operations with myectomy. In 522, myectomy was combined with mitral or subvalvular intervention. Reported operative mortality was 0.38%.","limit":"Historical selected centre population; the abstract does not name its single operator. These are not a stated personal outcome rate for Smedira or a direct comparison with Cui.","sources":["pc-cleveland1559"]}],"key_takeaways":[{"label":"More than muscle removal","text":"The plan can address an elongated mitral leaflet or abnormal papillary muscles when these contribute to obstruction.","sources":["pc-cleveland1559","pc-cleveland-podcast"]},{"label":"A defined assessment pathway","text":"A diagnostic visit without scheduled treatment generally involves 1–2 days in Cleveland, depending on testing.","sources":["pc-cleveland-pathway"]},{"label":"Historical surgical evidence","text":"The published series included 1,559 LVOT operations in 2005–2015, of which 1,530 involved myectomy.","sources":["pc-cleveland1559"]}],"patient_benefits":[{"text":"Specialist cardiology and imaging connect symptoms, dynamic obstruction and valve anatomy to a surgical plan.","sources":["pc-cleveland-pathway","pc-cleveland-podcast"]},{"text":"Myectomy can be combined with mitral or subvalvular correction during the same operation when anatomy requires it.","sources":["pc-cleveland1559"]},{"text":"An established pathway links diagnostic assessment, surgery and continuing HCM follow-up.","sources":["pc-cleveland-pathway"]}],"patient_limitations":[{"text":"The standard patient pathway describes sternotomy and cardiopulmonary bypass, so breastbone healing is part of recovery.","sources":["pc-cleveland-myectomy"]},{"text":"Historical centre results are not a current personal risk estimate or a direct comparison with another surgeon.","sources":["pc-cleveland1559"]},{"text":"Successful relief of obstruction does not remove the need for rhythm surveillance and wider HCM care.","sources":["pc-hcm-guideline"]}]},"ranking":{"engine_version":"reported-volume-v1","facts_digest":"b2057ed11422aaf9ecbef7849da5e5c2be583ed36f70e64a8a183767f7154fef","calculated_at":"2026-10-08","facts":[{"id":"cleveland-2024-myectomy","provider_id":"nicholas-smedira","family":"hcm","subject_scope":"programme","measurement":"annual","procedure":"septal_myectomy","inclusion_scope":"isolated-and-combined","value":201,"relation":"exact","display":"201","unit":"Septal myectomy with or without other procedures for HOCM","period_label":"Calendar year 2024","reported_as_of":"2024-12-31","method":"Programme total across septal approaches, including operations with associated procedures.","period_start":"2024-01-01","period_end":"2024-12-31","year":2024,"source":{"url":"https://consultqd.clevelandclinic.org/outcome-snapshots-thoracic-surgery-lung-transplant-more","title":"Cleveland Clinic 2024 HOCM data highlights","publisher":"Institution / clinical programme","published":"2025-08-27"},"checked_at":"2026-10-08"},{"id":"hcm-yong-cui-programme-annual-2024-over250","provider_id":"yong-cui","family":"hcm","subject_scope":"programme","measurement":"annual","procedure":"septal_myectomy","value":250,"relation":"more_than","display":"250+","period_label":"Calendar year 2024","reported_as_of":"2024-12-31","year":2024,"period_start":"2024-01-01","period_end":"2024-12-31","method":"Right infra-axillary modified-Morrow myectomies. This technique-specific count is a minimum for the programme’s total myectomy activity; other approaches are not included.","programme_id":"zhejiang","excluded_from_surgeon_operator_ranking":true,"source":{"title":"心有“勇”术｜崔勇：寻道创新，微步致远","publisher":"严道医声网","published":"2025-01-31","url":"https://www.drvoice.cn/article/16542"},"checked_at":"2026-10-08","inclusion_scope":"isolated-and-combined","research_executor":"installed local Hermes AIAgent"},{"id":"hcm-nicholas-smedira-participation-over2000","provider_id":"nicholas-smedira","family":"hcm","subject_scope":"surgeon_participation","measurement":"cumulative","procedure":"septal_myectomy","value":2000,"relation":"more_than","display":"2,000+","period_label":"Cumulative participation; myectomy-specific start and cutoff not stated","reported_as_of":null,"method":"The institutional profile attributes participation in septal myectomies to Smedira; it does not allocate all cases to him as sole operator.","programme_id":"cleveland","excluded_from_surgeon_operator_ranking":true,"source":{"title":"Dr. Nicholas Smedira, MD - Cleveland, OH - Cardiac Surgery - Request Appointment","publisher":"Cleveland Clinic","published":null,"url":"https://providers.clevelandclinic.org/provider/nicholas-smedira/4268212"},"checked_at":"2026-10-08","inclusion_scope":"isolated-and-combined","research_executor":"installed local Hermes AIAgent"},{"id":"hcm-nicholas-smedira-programme-period-over3500","provider_id":"nicholas-smedira","family":"hcm","subject_scope":"programme","measurement":"period_volume","procedure":"septal_myectomy","value":3500,"relation":"more_than","display":"3,500+","period_label":"2002–2021; exact boundary dates not specified","reported_as_of":null,"method":"Cleveland programme experience across 2002–2021, described by Milind Desai in an official clinical discussion. 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