What is a primary indication for coronary artery bypass grafting in patients with coronary artery disease?

• A. Three-vessel disease
• B. Single-vessel disease
• C. LAD stenosis < 50%
• D. Left ventricular hypertrophy with normal coronaries

Answer: (A)

When coronary bypass surgery is considered, the strongest signals are for revascularizing across multiple blocked arteries. Extensive multivessel disease, especially three-vessel involvement, is a primary indication for CABG because bypass grafts can restore blood flow to several areas of the heart in a durable way, offering better long-term outcomes in many patients (notably those with diabetes or significant left main/three-vessel disease).

In contrast, disease limited to a single vessel is often managed with medical therapy or less invasive approaches like PCI, and a moderate or mild LAD stenosis (less than significant narrowing) isn’t by itself an indication for CABG. Left ventricular hypertrophy with normal coronaries points to nonischemic heart disease rather than obstructive coronary disease, so CABG isn’t indicated for that scenario.