Coronary artery bypass grafting in patients with ventricular dysfunction

Ischaemic chronic heart failure represents one of the cardiovascular diseases with the worst degree of morbidity and mortality in the Western world, along with the highest healthcare costs. Despite several retrospective studies demonstrating that surgical revascularization (coronary artery bypass grafting), especially in the presence of viable myocardium, improves heart function and therefore survival in this subgroup of patients, the matter remains unclear and controversial. This chapter discusses the available evidence in the literature, from observational studies to randomized trials, including operative techniques and controversial issues, in order to clarify the role of coronary artery bypass grafting in the current management of patients with ischaemic left ventricular dysfunction.