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the U.S consider this a last frontier, and now we've shown these procedures are feasible here with a high level of success." Repair of atrial septal defects per- cutaneously is another procedure Dr. Khatri performs. Originally, these structural heart defects were treated only surgically by placing a patch over the "hole" after opening the chest. Over the past two decades, several devices have been available to close these defects through a catheter. However, the devices were rigid, and there was concern that over time, with the constant movement of the heart, they could potentially cause erosion in the walls of the heart. (According to Dr. Khatri, there have been some rare but documented cases where this has happened.) About five to six years ago, a new f lexible septal closure device was developed that eliminates the risk of erosion. In adults, the device is used to treat patients who have had strokes that cannot be explained. Also, it can be used to treat problems with pulmonary hypertension. "It's proven successful in limited applications in adults. Mainly, it is used for pediatric patients," says Dr. Khatri, who limits his practice to adults. Overall, Dr. Khatri attributes his Most coronary interventions performed at Southwest General by Dr. Jai Khatri are through the radial artery, instead of the femoral artery. He also performs transradial stenting of the carotid artery and of blood vessels in the kidneys, intestines and legs. chronic total occlusion (100 percent blocked artery). Up until very recently, the success rate in opening these types of blockages via PCI was only about 50 percent, according to Dr. Khatri. Today, he says, it's one of the main indications for referring a patient for bypass surgery "because most operators believe it's either too difficult to open or not worth the risk of attempting." He explains that over the past five years, 25 to 30 interventional cardiologists in the U.S. have adapted techniques developed in Japan for chronic total occlusion and have achieved high success rates — as high as 95 percent. "It's a small field, and we're still learn- ing a lot from our Japanese colleagues. Many interventional cardiologists in 8 | Cleveland-Akron-Canton MD NEWS n MDNEWS.COM n MARCH-APRIL 2012 success and that of Southwest General's Heart & Vascular Institute to the col- laborative efforts of the physicians and surgeons who work there and to the practitioners in the community who refer patients. "Patients referred to Southwest General's Heart & Vascular Institute enjoy the benefits of a multidisci- plinary, integrated care model. They get funneled to the doctor who can best meet their specific need," he says. "Referring physicians appreciate having their patients taken care of locally to facilitate coordination of care. Families appreciate not having to travel far to visit their loved ones. And that's for the betterment of the patient and the community." ■ PHOTO COURTESY OF PARMA HOSPITAL