Transplanted heart coronary artery disease (TxCAD) occurs in over 40% of orthotopic heart transplant (OHT) recipients and remains the leading cause of late post transplant mortality. The diffuse and distal character of TxCAD stenoses results in difficulties in selection of appropriate treatment methods.

Restenosis is the main factor limiting the long-term effectiveness of PCI in TxCAD. We present a case of a TxCAD patient with the left main coronary artery (LM) stenosis covering also proximal parts of the left anterior descending artery (LAD) and circumflex branch of the left coronary artery (Cx) treated simultaneously by drug-eluting stent (DES) and bare-metal stent (BMS) implantation. Significant restenosis was observed 6 months after BMS implantation in proximal Cx, while there was no restenosis in DES placed in LM and LAD revealed during 4-year follow-up.