Jack BOYD

Abstract Cardiac allograft vasculopathy (CAV) is the leading cause of mortality after heart transplantation, yet no targeted therapies exist to prevent or reverse disease progression, and patients with CAV ultimately require a retransplant. CAV is characterized by progressive neointimal hyperplasia in donor coronary arteries, resulting in luminal occlusion and eventual allograft failure.

Historically, the choice between coronary artery bypass grafting (CABG, commonly called bypass surgery) and percutaneous coronary intervention (PCI, commonly called stenting) for coronary artery disease (CAD) has been evaluated using superiority approaches that emphasize outcomes associated with traditional cardiovascular clinical trials.1–7 However, neither treatment approach has been definitively shown to be superior for all patients.