The role of multiple drug-eluting stents in the treatment of cardiac transplant vasculopathy.

A 60-year-old male with cardiac transplantation six years prior was seen for easy fatigability and dyspnea on exertion. Electrocardiogram revealed new T-wave inversions in the anterolateral leads. Cardiac catheterization showed diffuse multivessel disease with significant stenosis consistent with cardiac transplant vasculopathy (CTV). Percutaneous intervention was performed with DES with improvement of symptoms. Follow-up cardiac catheterization revealed patent stents. CTV is the most common cause of death in heart transplant patients. Due to denervated heart, these patients rarely experience chest pain. Revascularization options are limited given the diffuse nature of the disease. Due to their very low restenosis rates, DES may represent a viable alternative to retransplantation.