Cardiac allograft vasculopathy is one of the most common obstacles to the long-term survival of heart transplant recipients. Percutaneous transluminal angioplasty has been used as a palliative treatment for discrete lesions caused by this disease, but it is often complicated by restenosis. This report describes two cases in which directional coronary atherectomy was used to treat the discrete lesions and explores the possible advantages of this intervention in lieu of the traditional approach. Our results suggest that directional coronary atherectomy is a feasible alternative to conventional balloon angioplasty.
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