Coronary artery bypass grafting is the first-choice treatment for lesions of the left main trunk, but this procedure is associated with the problem of long-term graft patency. Some surgeons thus prefer to perform patch angioplasty for such lesions; however, the safety of this operation is not well established. Operative angioplasty using an ultrasonic aspiration system in a patient with ostial stenosis of the left coronary artery was successfully performed. This is the first report of the application of ultrasonic angioplasty to coronary artery disease.