ABSTRACT
Despite the success of medical therapy, percutaneous coronary interventions (PCI), and
coronary artery bypass grafting (CABG) in the treatment of coronary artery disease, there
are a significant number of patients with refractory angina due to diffuse coronary artery
disease that is not amenable to PCI or CABG. This severe coronary artery disease can lead
to incomplete revascularization following CABG and is noted to occur in up to 25% of
CABG surgery (1). This incomplete revascularization is a powerful independent predictor
of operative mortality and perioperative adverse events (1-3). Additionally, the presence
of diseased but non-grafted arteries carries a poor prognosis and poses a significant
negative influence leading to an increased incidence of death, recurrent angina,
myocardial infarction, and the need for repeat CABG (4-6).
