The Coronary Artery Surgery Study (CASS) trial, which compared the medical and surgical treatment of patients with chronic, stable coronary artery disease, revealed that coronary artery bypass graft (CABG) surgery is demonstrably effective for patients with left ventricular failure.1 Similarly, the Surgical Treatment for Ischemic Heart Failure (STITCH) trial, which investigated the effect of combining CABG with medical therapy in heart failure patients, demonstrated that, in patients with ischaemic cardiomyopathy, CABG results in a 21% reduction of death from cardiovascular causes at the 10-year follow-up.2 Dr Soltesz noted that although long-term survival was significantly increased, the risk of death is higher in the first 30 days, suggesting that therapies need to be focused on getting patients through that early hazardous period to reap the long-term benefits. Most early mortalities are due to PCCS, which occurs in 0.2–9% of cardiac surgeries, is difficult to predict and carries a high mortality rate, ranging from 10% to 75%.3,4 Of note, low ejection fraction, high-dose inotropes and long cardiopulmonary bypass (CPB) times are associated with increased risk.