Coronary heart disease (coronary atherosclerotic heart disease) is a common and frequent disease of the cardiovascular system. With the change of life style, the incidence of coronary heart disease in China also continues to increase. At present, there are three main means of treating coronary heart disease, namely, drug therapy, coronary artery bypass graft surgery (CABG) and percutaneous intervention (PCI). Drug therapy is the basis of coronary heart disease treatment, but when atherosclerotic plaque formation leads to irreversible stenosis, drugs cannot revascularize the coronary arteries, and people begin to look for ways to deliver blood to the coronary arteries again. The world’s first recognized successful coronary artery bypass surgery was performed by Russian cardiac surgeon Dr. Kolessov in 1964. Since then, bypass surgery has gone through the development from the use of venous bridges to fully arterialized bypass, from stop-beat bypass to non-stop bypass, and from a large incision in the middle of the sternum to a minimally invasive small incision bypass, and has become an important means of treatment for coronary heart disease with the excellent results of 10-year patency rate of venous bridges of more than 50%, and the patency rate of arterial bridges of 10 years of more than 90%. Another technique, interventional therapy, appeared in 1977, and the first case was done by a German-Swiss doctor. At that time, the means of interventional therapy was only balloon dilatation of narrowed coronary arteries, but 3 months after the operation, 30%~50% of patients experienced endovascular restenosis, and since then, the long-term effect of bare metal stents has been improved, but it still has a restenosis rate of 20%~30%. 2000, the drug-eluting stent was applied to the clinic, through the adherence of rapamycin or paclitaxel on the metal stent to inhibit the endothelial proliferation, and thus the endothelial proliferation of coronary artery disease. In 2000, drug-eluting stents were used in the clinic to reduce the stenosis rate by adhering rapamycin or paclitaxel to the metal stent to inhibit intimal hyperplasia. The introduction of drug stents, a time to make interventionalists and patients rush, the number of stenting cases all the way soaring, only in 2007 a year, China completed coronary heart disease interventional therapy 150,000 cases, stent implantation accounted for the vast majority. According to the U.S. National Center for Health Statistics, there are currently 1.3 million patients in the U.S. undergoing stenting each year, and 448,000 undergoing bypass surgery. Interventional treatments are less invasive, and patients can often be discharged from the hospital in three days and return to work in a few days. More and more patients are opting for stenting out of fear of the trauma of surgery, but it has also led to the misuse of stents. Some patients are put into dozens or even dozens of stents, resulting in the recurrence of the disease and the need for bypass surgery when there is no place to put the needle; or three vascular lesions that require surgical treatment of the patient because of being put into a stent and can not be operated. Once upon a time, there was no evidence to indicate whether interventional therapy could really compare to bypass surgery; now, with the release of the three-year clinical findings of the SYNTAX large-scale clinical trial (which included a total of 1,800 cases in 85 cardiac centers in Europe and the U.S.), the results of the comparison between CABG and PCI provide a certain basis for doctors’ practice in the future. It is also the first study to directly compare pharmacologic stents with bypass surgery. The results of the SYNTAX study, now in its third year of follow-up, show that major cardiovascular events such as infarction or stroke occurred in 28 percent of patients treated with stents, and in high-risk patients, the rate even reached 34.1 percent. In contrast, the probability of the same event in patients treated with bypass grafts was only 20.2%. In addition, within three years, the stent group had a 22 percent higher mortality rate than the surgical group, was about twice as likely to have a myocardial infarction, and required reoperation in one-fifth of the patients, compared to one-tenth in the bypass group. The study reaffirms that bypass surgery is a more appropriate treatment for patients with left main lesions, triple branch lesions, combined diabetes, long lesions, and complex lesions. Bypass surgery is also a poor choice for patients with poor cardiac function and a combination of other cardiac surgical diseases in addition to coronary artery disease. The SYNTAX trial will continue to follow these patients into their fifth year of life, and the advantage of bypass surgery lies in the long-term patency after 5 or even 10 years. In an interview with the Los Angeles Times, Dr. Michael Mack, first vice president of the American Association of Thoracic Surgeons, said, “Every time you compare bypass surgery to intervention, you find that the longer you go, the more the advantages of the surgery come through.” And with the development of minimally invasive techniques, such as non-stop bypass, small incisions, and thoracoscopic bypass, which can reduce the post-operative hospitalization days for bypass surgery to a few days, and allow patients to return to work weeks later, the level of invasiveness has been greatly reduced, while the results of the surgery remain the same. When choosing a treatment modality for coronary artery disease, one should not focus on the minimally invasive nature of interventional therapy and ignore the higher restenosis rate and the financial burden of repeated treatments, but rather focus on the patient’s specific situation and choose the modality that is most conducive to the long-term prognosis.