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Cardiogenic shock and cardiac arrest due to acute coronary syndromes are almost exclusively approached, as first-line treatment, with percutaneous coronary intervention. In a few instances, however, coronary artery bypass grafting may be the procedure of choice or necessary in life-threatening scenarios based on the failure of percutaneous coronary intervention due to unfavourable/unsuitable anatomical features or for complications arising from percutaneous coronary intervention. Coronary artery bypass grafting in cardiogenic shock or cardiac arrest is frequently characterized by challenging and disadvantageous clinical and haemodynamic conditions.