**5. Surgical option – CVBG versus traditional CABG**

There is no doubt that for patients with surgical triple-vessel coronary disease and a severely diseased left main artery, CABG appears to be preferable [15]. Despite constant advances in surgical and interventional therapy of coronary artery disease, there remains a group of patients who are not amenable to these traditional treatment strategies. Many patients being referred for CABG nowadays have far advanced CAD, which is often diffuse and exhibits poor vessel runoff. The idea of myocardial revascularization by means of grafting the coronary venous system is more than a century old; in cases of diffuse coronary artery disease, this may represent a valid therapeutic option [16].

The lack of suitable targets vessels remains a challenge for aortocoronary bypass grafting in diffuse coronary heart disease. Although this figure approximates 20% to 50% frequency reported in many series [17], our study represents a highly selective group with diffuse coronary disease in which CABG was not feasible with or without an endarterectomy.
