ON THE TITLE

MISTER.

In England, a surgeon who passes the examinations of the Royal College gives up the title of Doctor. The older title is the higher one.
It is earned twice.

108 HARLEY STREET · LONDON W1

MR JULIAN

ASHWORTH

FRCS (C-Th) · Consultant Cardiothoracic Surgeon

ROYAL BROMPTON HOSPITAL · IMPERIAL COLLEGE LONDON

THE SURGEON

Thirty-one years
inside the chest.

Julian Ashworth repairs hearts for a living and declines to be dramatic about it. Cambridge, the Royal College, a mitral fellowship in Ohio, then twenty-three years as a consultant at the Royal Brompton — the record is long, public, and audited.

His practice at 108 Harley Street is deliberately narrow: the operations he has done most, done best, done thousands of times. He operates on one person at a time, and tells each of them precisely what he intends to do before he does precisely that.

  • 1994FRCS (Cardiothoracic Surgery)
  • 2009Professor of Cardiac Surgery, Imperial College London
  • 2019Hunterian Professor, Royal College of Surgeons
Mr Julian Ashworth, photographed at 108 Harley Street
MR J. ASHWORTH · PHOTOGRAPHED AT 108 HARLEY STREET

THE RECORD

A career, kept
like a chart.

  1. 1986

    MB BChir, University of Cambridge

    First in year, clinical medicine. Elected to a college scholarship.

  2. 1991

    MRCS, Royal College of Surgeons of England

    Basic surgical training, St Thomas’ Hospital, London.

  3. 1994

    FRCS (Cardiothoracic Surgery)

    Admitted Fellow. Gives up “Doctor”; becomes “Mister”.

  4. 1996

    Fellowship in Mitral Valve Repair, Cleveland, Ohio

    Two years at the highest-volume valve centre in the world.

  5. 2001

    Consultant Cardiothoracic Surgeon, Royal Brompton Hospital

    Appointed at thirty-eight. Builds the mitral repair programme.

  6. 2009

    Professor of Cardiac Surgery, Imperial College London

    Chair in outcomes research. 148 peer-reviewed papers to date.

  7. 2014

    Private practice established, 108 Harley Street

    Consulting rooms two doors from where he first trained a registrar.

  8. 2019

    Hunterian Professor, Royal College of Surgeons

    The College’s oldest honour, for the mitral repair series.

  9. 2024

    Five-thousandth recorded operation

    Entered in the log like the first: date, procedure, outcome.

THE WORK

Selected cases.

Every operation is entered in the log. Three are shown here as they were imaged — each plate develops as it crosses the plane.

Fine suture work during mitral valve repair
CASE 001 / MITRAL

Mitral valve repair

Posterior leaflet prolapse. Repair, not replacement — the patient keeps her own valve, and her own future.

THEATRE 4 · 3 H 40 M · BYPASS 68 MIN · DISCHARGED DAY 5
Coronary angiogram showing grafted vessels
CASE 002 / CORONARY

Off-pump revascularisation

Three grafts placed on a beating heart. No bypass machine; nothing stopped that did not need stopping.

THEATRE 4 · 4 H 05 M · OFF-PUMP · HOME DAY 6
Operating theatre prepared for aortic root surgery
CASE 003 / AORTIC

Valve-sparing aortic root replacement

The root rebuilt, the patient’s own valve re-suspended inside it. A younger heart keeps its own parts.

THEATRE 2 · 5 H 20 M · CIRC ARREST 14 MIN · ECHO: TRIVIAL AR

THE PRACTICE

Five operations,
done extremely well.

A narrow practice is a deliberate one. Referrals are welcomed from cardiologists worldwide; every list is planned, and every operation performed, by Mr Ashworth personally.

  • LIST 01

    Mitral & tricuspid valve repair

    Repair over replacement, wherever anatomy allows. A repaired valve needs no anticoagulation and lasts a lifetime.

    3–4 H · REPAIR RATE 96.4%
  • LIST 02

    Coronary revascularisation, off-pump

    Grafting on the beating heart, arterial conduits first. Fewer transfusions, faster recoveries.

    3–5 H · ARTERIAL GRAFTS 82%
  • LIST 03

    Aortic root & arch surgery

    Valve-sparing root replacement and elective arch repair, planned from CT reconstruction to final echo.

    4–6 H · VALVE SPARED 8 IN 10
  • LIST 04

    Surgery for atrial fibrillation

    The Cox-maze procedure, alone or alongside valve repair. Rhythm restored in the same anaesthetic.

    +45 M · SINUS RHYTHM 89%
  • LIST 05

    Second opinions & remote review

    Imaging reviewed personally, worldwide, within five working days. Sometimes the best operation is none.

    WRITTEN OPINION · 5 DAYS

THE LOG, TO DATE

0OPERATIONS RECORDED
0% MITRAL REPAIR RATE
0PEER-REVIEWED PAPERS
0SURGEONS TRAINED

OUTCOMES AUDITED ANNUALLY · PUBLISHED VIA NICOR NATIONAL REGISTRY

Study of Mr Ashworth's hands
THE HANDS · STUDY, 2025

“He told me exactly what he would do.
Then he did exactly that.”

PATIENT · MITRAL REPAIR · 2023

CONSULTATIONS · TUESDAYS & THURSDAYS

MR JULIAN ASHWORTH FRCS (C-TH) · CARDIOTHORACIC SURGEON REQUEST A CONSULTATION
108 HARLEY STREET, LONDON W1G 6AJ
+44 (0)20 7946 0192 · PRACTICE@MRASHWORTH.CO.UK