Coronary Bypass Surgery with or without Surgical Ventricular Reconstruction

In a randomized trial, patients with coronary artery disease and an ejection fraction of 35% or less were randomly assigned to undergo either coronary-artery bypass grafting (CABG) or CABG plus surgical ventricular reconstruction. At a median of 48 months, there was no significant difference between the two groups in the primary outcome of death or hospitalization for cardiac causes. Patients with coronary artery disease and an ejection fraction of 35% or less were randomly assigned to undergo either coronary-artery bypass grafting (CABG) or CABG plus surgical ventricular reconstruction. At a median of 48 months, there was no significant difference in the primary outcome of death or hospitalization for cardiac causes. Coronary artery disease is the predominant cause of heart failure, which is a major cause of death and disability throughout the world. Evidence-based medical therapy has been shown to reduce symptoms and increase survival in patients with heart failure and coronary artery disease. 1 In addition, selected patients may benefit from surgical revascularization by means of coronary-artery bypass grafting (CABG), especially if the coronary anatomy is suitable for such surgery and if there is evidence of myocardial viability. 2 , 3 The reduction in left ventricular function that can occur after myocardial infarction is typically accompanied by left ventricular remodeling, a process that . . .