The role of coronary artery bypass grafting in patients with ischemic cardiomyopathy in the current era

Coronary artery bypass grafting (CABG) is widely accepted as the preferred treatment for left main or multi-vessel coronary artery disease, but benefit of CABG in patients with left ventricular dysfunction is not established. The most recent American College of Cardiology Foundation/American Heart Association 2013 Heart Failure Clinical Practice Guidelines state that either CABG or medical therapy is reasonable treatment for patients with severe left ventricular dysfunction (ejection fraction <35%), heart failure, and significant coronary artery disease; the indication is class IIa and level of evidence B (1).