My opinion is its always a good idea to get a second and third opinion just to make sure and it gives the patient a peace of mind that he hasn't overlooked any possibility of help available. Probably the reason for not getting a bypass would be that when your heart arteries are in that bad a shape its not just limited to the arteries in your heart, it's throughout ones body. Thats for everybody. We just find them in the heart first usually fm patients seeking medical care due to some heart related complaint or BP issues. The risks of the surgery probably outweigh the possible benefit which means its a little on the dangerous side and might not have a good outcome. And of course the rest of his health history factors into this- smoker? diabetic? hypertension? past cardiac events?  This is why we need to take care of ourselves early on because what you do early in your life will catch up to you in the long run.