Therefore, the choice of revascularization in patients with CAD and LV systolic dysfunction is best based on clinical variables (eg, coronary anatomy, presence of diabetes mellitus, presence of CKD), magnitude of LV systolic dysfunction, patient prefer- ences, clinical judgment, and consultation between the interven- tional cardiologist and the cardiac surgeon. 5.9.3. Previous CABG In patients with recurrent angina after CABG, repeat revas- cularization is most likely to improve survival in subjects at highest risk, such as those with obstruction of the proximal LAD artery and extensive anterior ischemia.1021 1025,1029 1032 Patients with ischemia in other locations and those with a patent LIMA to the LAD artery are unlikely to experience a survival benefit from repeat revascularization.1023 Cohort studies comparing PCI and CABG among post- CABG patients report similar rates of mid- and long-term survival after the 2 procedures.1022,1024,1025,1029,1031,1032,1106 In the patient with previous CABG who is referred for revascu- larization for medically refractory ischemia, factors that may support the choice of repeat CABG include vessels unsuitable for PCI, number of diseased bypass grafts, availability of the internal mammary artery for grafting chronically occluded coronary arteries, and good distal targets for bypass graft placement. Factors favoring PCI over CABG include limited areas of ischemia causing symptoms, suitable PCI targets, a patent graft to the LAD artery, poor CABG targets, and comorbid conditions. 5.9.4. 