Indications for CABG:
- PCI not feasible: tight left main disease, diffuse multivessel disease, or calcified coronaries.
- PCI not successful: inability to cross the lesion, in-stent stenosis.
- NYHA Functional class III - IV with chronic stable angina refractory to medical Tx.
- US refractory to medical Tx.
- Dissection or acute ischemia following PCI - angioplasty or stenting.
- Early post-infarction ischemia - acute evolving MI, less than 4 - 6 hours of the onset of chest pain.
- Positive stress test prior to major intra-abdominal or vascular surgery.
- Ischemic pulmonary edema in elderly women.
- L. main disease >50%.
- 3 vessel disease with EF <50%.
- 3 vessel disease with EF >50% and significant inducible ischemia.
- 2-vessel disease with proximal LAD involvement.
- 1 or 2 vessel disease with extensive myocardium in jeopardy but lesions not amenable to PCI.
- Valvular operation, septal myectomy with associated CAD.
- Post-infarction mechanical defects: LV aneurysm, ventricular septal rupture, acute MR.
- Coronary artery anomalies with risk of sudden death (vessel passing between aorta and pulmonary artery).