Reply to the article: Nicholas C. Dang, Abbas Ardehali, Brian A. Bruckner, Patrick E. Parrino, Daniel L. Gillen, Rachel W. Hoffman, Russell Spotnitz, Stephanie Cavoores, Ian J. Shorn, Roberto J. Manson, William D. Spotnitz. Prospective, multicenter, randomized, controlled trial evaluating the performance of a novel combination powder vs hemostatic matrix in cardiothoracic operations. J Card Surg. 2019;1-7. DOI: 10.1111/jocs.14376.