Isaac Hariton, an 86-year-old retired surgeon from Aventura, had a clogged heart valve that was life-threatening. His age and physical condition meant he was not a candidate for open-heart surgery to fix it. University of Miami doctors told him of an alternative - an artificial valve that could be inserted through an artery in his leg. One catch: The device, called the CoreValve, was approved for use in Europe and much of the rest of the world, but not the United States. If he wanted the new valve, UM doctors recommended he go to Cali, Colombia. Hariton went. A UM doctor flew down to assist with the procedure. That meant an American patient and an American doctor flew 1,500 miles to use an American-made device. But since American regulators hadn't approved it, American insurance didn't pay. Hariton's out-of-pocket cost: $51,000.