Revascularization in Patients with Reduced Left Ventricular Function

Patients with reduced left ventricular (LV) function due to coronary artery disease are at risk of both sudden cardiac death and increased long-term mortality. Early landmark clinical trials proved benefits of coronary artery bypass grafting (CABG) compared to medical therapy with respect to symptoms and prognosis. Data comparing percutaneous coronary intervention (PCI) and CABG in coronary patients with depressed LV function are scarce because these patients were excluded in most revascularization trials. However, data derived from subgroups, registries and meta-analyses suggest preference of CABG in complex multi-vessel disease, whereas PCI is a valuable less invasive alternative in less complex coronary anatomy. The choice of the procedure should be made by the heart team.