Reply to Almdahl

We thank S.M. Almdahl for his discussion [1] regarding our manuscript on surgical patch angioplasty [2]. He presents their method of this technique on two subjects utilizing autologous aortic tissue. Surgical angioplasty was performed with an oval piece of non-diseased ascending aorta by suturing this as a coronary patch using Dion’s technique [3]. This has previously been described by Bilal et al. [4], who successfully employed a triangular piece of an autologous aortic patch for surgical angioplasty in 11 patients with follow-up ranging from 1 to 94 months. At a mean of 44-month follow-up, CT coronary angiography demonstrated a patent left main coronary artery in all patients [4]. Taken together, these operative series demonstrate the role of surgical patch angioplasty as a therapeutic option for ostial coronary disease and highlight the need for further research and clinical trial evidence in the application of this technique.