Coronary artery bypass grafting (CABG) as a means of coronary revascularization is indicated when:

1. PCI fails and there are persistent symptoms or hemodynamic instability
2. A patient is not a candidate for PCI and has continued symptoms with a significant area of myocardium at risk
3. At the time of ventricular septal defect or mitral valve repair
4. When left main coronary disease or 3-vessel coronary disease is present with cardiogenic shock or ventricular arrhythmias (ventricular tachycardia or fibrillation)

CABG is NOT indicated when there is a small area of myocardium in jeopardy and the patient is stable.