Myocardial Hybrid Revascularization Versus Coronary artERy Bypass GraftING for Complex Triple-vessel Disease

Inclusion Criteria: * Triple-vessel disease with proximal or mid LAD disease with angiographic diameter stenosis \> 70% by visual analysis in all three territories, requiring myocardial revascularization OR triple-vessel disease with proximal or mid LAD disease with angiographic diameter stenosis 50-70% by visual analysis in any territory but with invasive or non-invasive evidence of flow-limiting stenosis in all three territories, requiring myocardial revascularization * Total SYNTAX score \> 22 * LCx and RCA territories estimated to be equivalently revascularized by either PCI or CABG, with at least one major non-LAD vessel to be treated * Clinical and anatomic eligibility for both PCI and CABG as agreed to by both interventional and surgical consensus * Interventionalist determines PCI appropriateness and eligibility * Surgeon determines surgical appropriateness and eligibility * Silent ischemia, stable angina, unstable angina or recent MI * If recent MI, cardiac biomarkers must have returned to normal prior to randomization * Ability to sign informed consent and comply with all study procedures Exclusion Criteria: * Prior PCI or CABG at any time prior to randomization * Need for any concomitant cardiac surgery other than CABG (e.g. valve surgery, aortic repair, etc.), or intent that if the patient randomizes to surgery, any cardiac surgical procedure other than isolated CABG will be performed * Patients unable to tolerate, obtain or comply with dual antiplatele…