Coronary artery bypass surgery indications

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-in-Chief: Cafer Zorkun, M.D., Ph.D. [2], Mohammed A. Sbeih, M.D. [3] Anahita Deylamsalehi, M.D.[4]

Overview

Coronary artery bypass surgery (CABG) is the preferred treatment with:
- Disease of the left main coronary artery (LMCA). LMCA disease is associated with sudden death; therefore, lesions of the LMCA are sometimes referred to as widow makers.
- Disease of all three coronary vessels (LAD, LCX and RCA).
- Diffuse disease not amenable to treatment with PCI.
- Coronary artery bypass surgery (CABG) is likely the preferred treatment with other high-risk patients such as those with severe ventricular dysfunction (i.e. low ejection fraction), or diabetes mellitus patients, particularly those with disease involving the left anterior descending artery.
Alternative treatments for coronary artery disease include:
- Medical management (statins, antihypertensives, smoking cessation, and tight blood sugar control in diabetics).
- Both Percutaneous coronary intervention (PCI) and Coronary artery bypass surgery (CABG) are more effective than medical management at relieving symptoms, (e.g. angina, dyspnea, fatigue), but repeated procedures are required more frequently after PCI.
When optimal treatment strategy is unclear for a patient, it is recommended to have a multidisciplinary Heart Team approach.^[1]
Decision regarding the treatment should be patient centered.^[1]

You can read in greater detail about each of the indications for CABG below in greater detail by clicking on the link.