What is the primary indication for CABG in patients with multivessel coronary artery disease?

• A. Relieve angina and improve survival by bypassing obstructed coronary arteries when medical therapy or PCI is insufficient or unsuitable, especially for left main or multivessel disease.
• B. Prolongs hospital stay and increases risk without improving outcomes.
• C. Revascularizes only when there is single-vessel disease.
• D. Is primarily used to treat arrhythmias.

Answer: (A)

The main idea being tested is when CABG is indicated for multivessel coronary artery disease. CABG is pursued to relieve ischemic symptoms (angina) and to improve overall survival by bypassing obstructed arteries when optimal medical therapy or PCI is not enough or not suitable, with particular emphasis on left main or extensive multivessel disease. The operation offers durable, long‑term revascularization, reducing recurrent ischemia and the need for repeated procedures. In certain patients, such as diabetics with multivessel disease, CABG has been shown to provide a survival advantage over other revascularization approaches. It is not aimed at treating arrhythmias, and it is not limited to single-vessel disease; the strongest justification rests on achieving meaningful symptom relief and prognosis improvement in complex, multivessel anatomy when less invasive options are inadequate.