The invention describes includes a device and method for dilating a coronary arterial stenosis and for creating a transection in the myocardium. The transection creates a new artery composed partially of the old artery and partially of the normal healing tissue and myocardium. Several dilating means are described, as well as several cutting means and alignment means by which the cutting means may be located and properly oriented. In operation, the dilating means, cutting means and alignment means are advanced in the distal end of a catheter, which may be guided into position by a guidewire.