Inclusion Criteria:

• LVEF less than .35, as measured by CMR ventriculogram, gated SPECT ventriculogram, echocardiography, or contrast ventriculogram within 3 months of study entry
• Has CAD suitable for revascularization
• Absence of left main CAD, as defined by an intraluminal stenosis of 50% or greater (to be eligible for MED Therapy)
• Absence of Canadian Class III angina or greater (angina markedly limiting ordinary activity) (to be eligible for MED Therapy)
• Dominant akinesia or dyskinesia of the anterior left ventricular wall amenable to SVR (to be eligible for SVR)

Exclusion Criteria:

• Aortic valvular heart disease clearly indicating the need for aortic valve repair or replacement
• Cardiogenic shock (within 72 hours of study entry), as defined by the need for intra-aortic balloon support or the requirement for intravenous inotropic support
• Plan for percutaneous intervention of CAD
• Recent acute myocardial infarction judged to be an important cause of left ventricular dysfunction
• History of more than one prior coronary bypass operation
• Non-cardiac illness with a life expectancy of less than 3 years
• Non-cardiac illness imposing substantial operative mortality
• Conditions or circumstances likely to lead to poor treatment adherence (e.g., history of poor compliance, alcohol or drug dependency, psychiatric illness, no fixed address)
• Previous heart, kidney, liver, or lung transplantation
• Current participation in another investigational drug or investigational medical device study
• Women of childbearing potential