The SYNTAX Score is a tool developed in connection with the SYNTAX Trial, a trial comparing PCI and Cardiac Surgery in complex, high-risk Left Main and/or 3Vessel Disease patients.
Although Syntax asserts that once completed it will provide an answer to the making a choice between CABG and PCI, this score is heavily biased towards PCI. Only if PCI is judged to be of high risk is CABG recommended. With that in mind, it is primarily a tool for interventionalists. Surgeons are only concerned with the general condition of the patient, the condition of the heart and whether there is adequate coronary outflow. Most literature strongly supports a bypass procedure in these type of patients, unless there are prohibitive operative risks involved, most of which also influence the risk of PCI.