Dr. Hirai is an interventional cardiologist and is one of the few formally trained operators in high-risk coronary interventions.

Dr. Hirai specializes from regular percutaneous coronary intervention (PCI) to chronic total occlusion (CTO) intervention, which is the most challenging coronary intervention. Patients with CTO (100% blockage) are often told by their treating physicians “there are no other options” and continue to suffer from chest pain or shortness of breath that limits their activity. CTO intervention has shown to improve patient’s quality of life and Dr. Hirai is passionate about helping this patient population. His research focus is on how to perform CTO intervention safely and efficiently for the patients. He is also well-trained in robotic-assisted PCI and he was an invited speaker at ARIA meeting in Japan, 2018, TOPIC meeting and Toyohashi live in 2019, Japan.

Education & Training

Medical School

Nagoya University


Internal Medicine

  • Loyola University of Chicago, Stritch School of Medicine

Preliminary Medicine

  • Yokohama City University


Interventional Cardiology

  • St. Luke's Hospital of Kansas City
  • University of Chicago

Cardiovascular Disease

  • Loyola University of Chicago, Stritch School of Medicine


American Board of Internal Medicine
American Board of Internal Medicine/Cardiovascular Disease
American Board of Internal Medicine/Interventional Cardiology

Commercial Relationships and Collaborations

This faculty member or a member of his or her immediate family has a working relationship, such as providing consulting, research, or educational services, with the companies listed below. These relationships have been reported to the University of Missouri and, if appropriate, plans have been established to address potential conflicts. The following relationships were reported as of July 2020.



MU Health Care participates with most major managed care organizations. To find out whether MU Health Care is a participating provider in your insurance plan or network, or for information on co-payments and deductibles, please contact your insurance carrier directly.

Academic Information

Research Interests

  • Chronic total occlusion intervention
  • Robotic-assisted percutaneous coronary intervention
  • High-risk coronary intervention
  • ASD/PFO closure


  • Hirai T, Grantham JA, Kandzari DE, Ballard W, Brown WM, Allen KB, Kirtane AJ, Argenziano M, Yeh RW, Khabbaz K, Lombardi W, Lasala J, Kachroo P, Karmpaliotis D, Gosch KL, Salisbury AC; OPTIMUM Study Group. Percutaneous ventricular assist device for higher-risk percutaneous coronary intervention in surgically ineligible patients: Indications and outcomes from the OPTIMUM study, Catheter and Cardiovascular Interventions 2023 Sep 7. PMID: 37676058
  • Kohsaka S, Ejiri K, Takagi H, Watanabe I, Gatate Y, Fukushima K, Nakano S, Hirai T, Diagnostic and Therapeutic Strategies for Stable Coronary Artery Disease Following the ISCHEMIA Trial, JACC;Asia 2023 3 (1) 15-30. PMID: 36873769
  • Chitturi KR, Kanake S, Nguyen T, Loc B, Baden K, Bavishi C, Kumar A, Liu Z, Chan A, Karuparthi PR, Hirai T, Implementation of Robotic-Assisted Percutaneous Coronary Intervention into a High-risk PCI program. Cardiovascular Revascularization Medicine 2022, Oct;43:115-119, PMID: 35610138 
  • Hirai T, Grantham JA, Sapontis J, Nicholson WJ, Lombardi W, Karmpaliotis D, Moses J, Nugent K, Gosch KL, Salisbury AC. Development and validation of a prediction model for angiographic perforation during chronic total occlusion percutaneous coronary intervention: OPEN-CLEAN perforation score, Catheter and Cardiovascular Interventions 2022 Feb;99(2):280-285, PMID 33438824
  • Hirai T, Grantham JA, Indications and Patient Selection for Percutaneous Coronary Intervention of Chronic Total Occlusions, Interventional Cardiology Clinics 2021 Jan;10(1):1-5. PMID: 33223098
  • Hirai T, Grantham JA, Perforation Mechanisms, Risk Stratification and Management in the post-CABG Patient, Interventional Cardiology Clinics 2021 Jan;10(1):101-107. PMID: 33223099
  • Hirai T, Grantham JA, Gosch KL, Patterson C, Kirtane AJ, Lombardi W, Nicholson WJ, Moses J, Karmpaliotis D, Salisbury AC, Impact of Subintimal or Plaque Modification on Repeat Chronic Total Occlusion Angioplasty Following an Unsuccessful Attempt, JACC Cardiovascular Interventions 2020 Apr 27; 13(8):1010-12. PMID 32327084
  • Hirai T, Kearney K, Kataruka A, Gosch KL, Brandt H, Nicholson WJ, Lombardi W, Grantham JA, Salisbury A, Initial Report of Safety and Feasibility of Robotic-assisted Chronic Total Occlusion Coronary Intervention, Catheter and Cardiovascular Interventions. 2020 Jan;95(1):165-169. PMID: 31483078
  • Patterson C, Sapontis J., Nicholson WJ, Lombardi W, Karmpaliotis D, Moses J, Gosch KL, Grantham JA, Hirai T, Impact of body mass index on outcome and health status after chronic total occlusion percutaneous coronary intervention: Insights from the OPEN-CTO study Catheter Cardiovascular Interventions 2020 Apr 22, PMID 32320140
  • Hirai T, Nicholson WJ , Sapontis J., Salisbury AC, Marso SP, Lombardi W, Karmpaliotis D, Moses J, , Pershad A , Wyman MR , Spaedy A , Cook S, Doshi P , Federici R, Nugent K, Gosch KL, Spertus JA, Grantham JA A Detailed Analysis of Perforations during Chronic Total Occlusion Angioplasty, JACC Cardiovascular Interventions 2019 Jun 19. pii: S1936-8798(19)31164-1. PMID: 31255554
  • Hirai T, Grantham JA, Sapontis J., Cohen D, Marso SP, Lombardi W, Karmpaliotis D, Moses J, Nicholson WJ, Pershad A , Wyman MR , Spaedy A , Cook S, Doshi P , Federici R, Nugent K, Gosch KL, Spertus JA, Salisbury A Quality of Life in Patients with Refractory Angina after Chronic Total Occlusion Angioplasty, Circulation Cardiovascular Interventions. 2019 Mar;12(3), e007558, PMID: 30871356
  • Hirai T, Qintar M, Grantham JA, Sapontis J, Cohen DJ, Lombardi W, Karmpaliotis D, Moses J, Nicholson WJ, Nugent K, Gosch KL, Spertus JA, Salisbury AC. Patient Characteristics Associated With Antianginal Medication Escalation and De-Escalation Following Chronic Total Occlusion Percutaneous Coronary Intervention Circ Cardiovasc Qual Outcomes. 2019 Jun;12(6):e005287. doi: 
  • Qintar M, Hirai T, Arnold SV, Sheehy J, Sapontis J, Jones P, Tang Y, Lombardi W, Karmpaliotis D, Moses J, Patterson C, Nicholson WJ, Cohen DJ, Spertus JA, Grantham JA, Salisbury AC, De-escalation of antianginal medications after successful chronic total occlusion percutaneous coronary intervention: Frequency and relationship with health status. American Heart Journal, 2019 April 26;214:1-8, PMID: 31152872
  • Hirai T, Grantham JA, Sapontis J., Cohen D, Marso SP, Lombardi W, Karmpaliotis D, Moses J, Nicholson WJ, Pershad A, Wyman MR , Spaedy A , Cook S, Doshi P , Federici R, Nugent K, Gosch KL, Spertus JA, Salisbury A, Impact of Subintimal Plaque Modification Procedures on Health Status after Unsuccessful Chronic Total Occlusion Angioplasty Catheter and Cardiovascular Interventions 2018 May 1;91 (6):1035-1042. PMID: 29068126
  • Kitahara H, Hirai T, McCrorey M, Patel B, Nisivaco S, Nathan S, Balkhy H Advanced Hybrid Coronary Revascularization: Mid-term Outcomes with Robotic Beating Heart Connector Totally Endoscopic Multi-vessel Grafting and PCI. J Thorac Cardiovasc Surg. 2018 Nov 14, PMID: 30635190
  • Hirai T, Jones D, Tate S, Dryer K, Santiago L, Edelson D, Friant J, Nathan S, Shah A, Paul J, Blair J. Cardiac Arrest Triage score best predicts mortality after intervention in patients with massive and submassive pulmonary embolism. Catheter and Cardiovascular interventions 2018 Aug 1;92(2):366-371. PMID: 29745451
  • Sapontis J, Salisbury AC, Yeh RW, Cohen DJ, Hirai T, Lombardi W, McCabe JM, Karmpaliotis D, Moses J, Nicholson WJ, Pershad A, Wyman RM, Spaedy A, Cook S, Doshi P, Federici R, Thompson CR, Marso SP, Nugent K, Gosch KL, Spertus JA, Grantham JA. Early Procedural and Health Status Outcomes after Chronic Total Occlusion Angioplasty: A Report From the OPEN-CTO Registry (Outcomes, Patient Health Status, and Efficiency in Chronic Total Occlusion Hybrid Procedures). JACC Cardiovascular Intervention 2017 Aug 14;10 (15) :1523-1534. PMID: 28797429
  • Bharmal M, Venturini JM, Chua RFM, Sharp W, Beiser DG, Tabit C, Hirai T, Rosenberg JR, Friant J, Blair JEA, Paul JD, Nathan S, Shah AP, Cost-utility of extracorporeal cardiopulmonary resuscitation in patients with cardiac arrest, Resuscitation. 2019 Feb 1. PMID: 30716427
  • Hirai T, Rosenberg J, Nathan S, Blair J, Broken Arrow: Successful Retrieval of a Dislodged Coronary Orbital Atherectomy Microtip Catheter Cardiovascular Interventions 2018 Sep 1;92(3):511-514 PMID 30019818