A 38-year-old man underwent replacement of the ascending aorta and aortic arch for acute type A dissection. On the 11th postoperative day he developed mediastinitis. Omental transposition was performed successfully. The patient was readmitted for bloody discharge from the wound. He suffered from back pain suddenly. Computed tomography and aortography revealed an anastomotic pseudoaneurysm of the ascending aorta. Emergency reoperation to replace the ascending aorta with a new prosthesis was performed. The postoperative course was uneventful.

 Living overseas affects heath significantly. This needs to be addressed adequately for Japanese who live in the U. S. based on the existing evidence of negative impacts on health such as increased coronary heart disease mortality and stress. In addition to care at individual level as primary care providers, community-oriented primary care (COPC) provides primary care physicians with great potential to use as a tool of community medicine to improve their health at the community level. In this article, we report our case of COPC activity ; defining the community, choosing the health issue, implementing an intervention and its initial evaluation as well as the process of involving the community targeting Japanese in Pittsburgh, USA. The present article also includes a hypothesis-driven research question, measurement, analysis and the results followed by discussion with the lessons learned through our COPC activities. This article will not only inform readers of the COPC case but also provide practical and applicable insight to community medicine in readers' settings.