Hello thanks for posting here. I have gone through your description. She has critical heart disease involving the three arteries if the heart. And since her pumping function has dropped to 27%, she definitely has had a heart attack. so once blocked arteries in the heart are diagnosed, there are two methods to open it. angioplasty and bypass surgery. As your doctor has adviced angioplasty cannot be done because of triple vessel disease and also involving the arteries where they bifurcate. So surgery is the only option in her. Surgery with a low pumping function is definitely riskier than one with a normal function. But here you have to assess the risk versus benefits. If you don t do the surgery then you are not treating the cause. Her quality of life will be poor, she will get tired easily and she stands the probability of having further heart attacks also which will further decrease the function. Going ahead with the surgery will improve quality of life, she can do her day to day activities, travel etc. however despite surgery pumping function will not increase more than 35%. But the risks of heart attacks is evaded. Another thing that should be considered is how mobile she is. As you said she has left sided weakness. If she is bed bound and requires help for her day to day activities, then a surgery would be more of a suffering to her. A CABG surgery has a good outcome and patients usually do well for 12-15 years. Now a days with advanced technologies and approaches, heart surgery risks have come down a lot. I personally have seen patients with 25-30% do well with CABG. So my advice is it will be worthwhile to take a call for CABG. (only if she is ambulatory and you want to increase quality of her life) wishing her good health Regards