Written By: Adam Pick, Patient Advocate, Author & Website Founder
Published: April 4, 2026
I just received a fascinating email from Andy Roe, an American living in Japan with his wife and five children. In his email, Andy shared that his 11-month old son, Luca, was diagnosed with severe aortic stenosis. Like many parents, Andy researched the Ross Procedure, an advanced type of aortic valve replacement operation, that might help Luca. However, Andy was surprised to learn that human donor valve replacements, which are an essential part of the Ross Procedure, are not available in Japan. Instead, Luca would get a custom Polytetrafluoroethylene (PTFE) Valved Conduit.
Andy Says…
With his permission, I am honored to share Andy’s email to help educate the parents in our community about this unique type of Ross Procedure. Here is what Andy wrote to me:
Hi Adam, I am an American living in Japan. My son was born with aortic stenosis. Three weeks ago, at 11 months old, he underwent the Ross Procedure. But, it was a little different than the traditional Ross Procedure.
Since my son’s Ross Procedure was performed in Japan, we do not use human donor valves to replace the pulmonary valve. Instead, a Polytetrafluoroethylene (PTFE) Valved Conduit made from Gore-Tex was used in the pulmonary position. Luca’s surgeon, Dr. Masahiko Nishioka, Chief of Pediatric Cardiovascular Surgery at Nanbu Children’s Hospital in Okinawa, Japan, showed me one of these valves. The surgeon actually hand-crafted my son’s new valve. He said it took him 3 hours to make. There seems to be a lot of benefits for this type of valve:
- Crafted to be a perfect fit patent
- No possibility of rejection
- Extremely durable
- No or low calcification
- Good blood flow
- Low infection rate
- No blood thinners necessary
Looking at the advantages of PTFE (Gore-Tex–type) valved conduits, I was wondering why I have never heard of them used in the United States. I believe it was the medical folks in Japan who came up with this approach.
The day before the surgery pre-op meeting, I asked Dr. Nishioka about this valve. He told me that he had actually made one just the previous week. He explained that he uses a single sheet of material and carefully constructs the valve by hand. Using my son’s imaging, the surgeon was able to create a valve that is perfectly sized for him.
Dr. Nishioka told us that he has made and used over 70 of these PTFE valves. Not only for Ross Procedures, but other surgeries as well. He only does 2-3 Ross Procedures per year but he does over 100 heart surgeries on children every year. I believe Dr. Nishioka is one of the best surgeons in Japan. He posts all of his stats and patient outcomes online — which is pretty unusual I think.
How Is Luca Doing Now?
Luca is doing great. The surgery was a huge success and our family is so happy.
Our son will need another open-heart surgery in the future to replace this handmade valve. It will most likely be replaced with a PTFE Valved Conduit. Hopefully the next valve will be an adult size. Then, if anything else would be needed in Luca’s future, the medical team could just use TAVR.
Thank you again for your encouragement and for the work you do to support families like ours. Your videos really helped me become much more knowledgeable about aortic stenosis and many other things regarding the heart. I appreciate what you do!
Related Links:
Best regards,
Andy Roe
Okinawa, Japan
