Cardiac allograft vasculopathy (CAV) is the most common cause of long-term graft failure after heart transplantation. In the absence of a specific treatment for this condition, percutaneous coronary revascularization (PCI) has been the main palliative treatment. Although long-term results are unknown, use of drug-eluting stents (DES) has been shown to have favorable outcome when used in heart transplant patients for treatment of focal lesions in CAV. We report the case of a 77-year-old male who presented with restenosis secondary to DES stent fracture (SF) after treatment of CAV with sirolimus-eluting stents (SES). © 2010 Elsevier Inc. All rights reserved.