Successful Ascending Aortic Replacement via Minimally Invasive Cardiac Surgery (MICS)

## Press Release Information
Title: Successful Ascending Aortic Replacement via Minimally Invasive Cardiac Surgery (MICS)
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Body (first 8000 characters): A team led by Dr. Toru Koakutsu of NewHeart Watanabe International Hospital (Suginami-ku, Tokyo, Director: Tsuyoshi Watanabe) successfully performed the first right mini-thoracotomy ascending aortic artificial blood vessel replacement (Minimally Invasive Cardiac Surgery, Ascending Aortic Replacement) on a female patient in her 70s diagnosed with an ascending aortic aneurysm on April 24, 2026. The incision was only 8cm, which is significantly smaller than the conventional 20cm median sternotomy that involves cutting vertically down the middle of the chest, characterized by less physical burden. In March of the same year, the hospital also successfully performed a right mini-thoracotomy aortic root replacement (MICS-Bentall) on a male patient in his 60s with aortic annulus dilatation and aortic regurgitation. The hospital plans to actively continue performing minimally invasive surgeries for thoracic aortic diseases.

Image of the incision for MICS ascending aortic artificial blood vessel replacement

1. What is a Thoracic Aortic Aneurysm?

A thoracic aortic aneurysm is a vascular disease where the large blood vessel emerging from the heart expands to 4.5-5cm or more. The main cause of aortic aneurysms is arteriosclerosis. They often grow without symptoms and are accidentally discovered during workplace health check-ups. Aortic aneurysms do not naturally shrink and can be fatal if they rupture, thus requiring aggressive surgical treatment.

2. What is Artificial Blood Vessel Replacement Surgery?

Artificial blood vessel replacement surgery is an operation to replace an enlarged aorta (aortic aneurysm) with an artificial blood vessel. This is usually performed via a median sternotomy, which involves a vertical incision of about 20cm through the sternum, which is about the size of a kamaboko board. However, post-operative pain, sternal infection, and activity restrictions until the sternum heals (about 2-3 months) have been challenges for early social reintegration.

This time, our hospital performed right mini-thoracotomy ascending aortic artificial blood vessel replacement surgery with the aim of reducing physical burden and promoting early social reintegration. Even with a small incision, selective cerebral perfusion was used to reliably maintain cerebral circulation, similar to a median sternotomy. Furthermore, by performing the surgery quickly at a mild hypothermia of 32°C, complications due to excessive body temperature reduction were mitigated.

The post-operative course of the patient who underwent this surgery was very good; she began walking training the day after the surgery and was discharged independently on the 13th day post-surgery.

Artificial blood vessel used (Jgraft 28mm)

For more details, please visit: https://newheart.jp/blog/archives/1643/

3. Features of NewHeart Watanabe International Hospital

NewHeart Watanabe International Hospital boasts an overwhelming number of robot-assisted cardiac surgeries and actively performs minimally invasive surgeries for numerous patients with cardiac and vascular diseases. To save as many patients suffering from illness as possible, we constantly pursue the most advanced and highest-level techniques, and daily practice medicine with the motto of "safe and gentle on the body."

Dr. Tsuyoshi Watanabe, the hospital's director, states, "Even for diseases where robot surgery is not yet applicable, we want to deliver safe treatment with small incisions that are less burdensome on the body." Dr. Toru Koakutsu, the attending physician, says, "We want to provide safe treatment using our hospital's technology to many patients who have been told that surgery for ascending aortic aneurysms cannot be done with small incisions."

[Cardiovascular Surgeon Tsuyoshi Watanabe]

Director of NewHeart Watanabe International Hospital. After graduating from Kanazawa University School of Medicine, he studied at the Department of Cardiovascular Surgery, Hannover Medical School, Germany, and became the youngest Japanese heart transplant surgeon at 32. After returning to Japan, he successfully performed the first off-pump coronary artery bypass surgery and awake cardiac surgery in Japan. He is the only one in Japan performing keyhole cardiac surgery using the surgical assistance robot "da Vinci," and has performed the most robot-assisted cardiac surgeries worldwide for six consecutive years since 2019.

Tsuyoshi Watanabe Official Website: https://doctorblackjack.net

[Cardiovascular Surgeon Toru Koakutsu]

Cardiovascular Surgery, NewHeart Watanabe International Hospital. Graduated from Kanazawa Medical University School of Medicine in 2016. Certified Cardiovascular Surgeon. Certified Minimally Invasive Cardiac Surgeon. Robo-Doc Pilot (Class A in Japan).

Hospital Overview
Hospital Name: NewHeart Watanabe International Hospital
Operating Corporation: Medical Corporation Tokyo Ishinkai
Location: 3-19-11 Hamadayama, Suginami-ku, Tokyo 168-0065
TEL: 03-3311-1119 (Reception: Weekdays 9:00-16:00)
URL: https://newheart.jp/
Center Details: https://newheart.jp/subject/adult_congenital_center.php
Inquiries: Free email consultation <https://newheart.jp/outpatient_clinic_form1/form
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