Emperor Akihito will undergo heart bypass surgery Saturday at University of Tokyo Hospital, the Imperial Household Agency said Sunday, after an angiogram performed the previous day showed the further narrowing of two branches of his left coronary artery.

A team of doctors decided to conduct the surgery after consulting the Emperor about it, the agency said. It will be the first surgery for the 78-year-old Emperor since 2003, when he had surgery for prostate cancer.

The Emperor underwent an angiogram for about an hour Saturday to examine his cardiac function before leaving the hospital Sunday. The test was performed after the Emperor displayed symptoms of a minor ischemic change while recently engaging in light exercise, according to the agency.