A patient is described in whom severe cardiac dysfunction developed from amyloid deposited entirely in the walls and lumens of intramural coronary arteries, underwent cardiac transplantation, survived another 69 months, died suddenly, and at necropsy had amyloid again limited to the walls and lumens of the intramyocardial coronary arteries in the donor heart. The rather lengthy survival in this patient and the 118-month survival in a similar previously reported patient suggests that cardiac transplantation may be an appropriate procedure for some patients with cardiac amyloidosis.