According to the latest domestic statistics, the incidence and mortality rate of lung cancer in large and medium-sized cities in China rank first among malignant tumors, and there are about 500,000 new cases of lung cancer in China every year. China is expected to become the world’s largest lung cancer country by 2015 due to the large smoking population and the relatively low level of tobacco control. Since early diagnosis of lung cancer is still difficult, more than half of the lung cancer patients are already in advanced stage when they are diagnosed, losing the chance of radical surgery, so some experts predict that 1.8 million people will die of lung cancer in China by 2033, and the situation of lung cancer prevention and treatment is quite serious. Coronary atherosclerotic heart disease (CHD) is another common and serious disease that threatens human beings, and is the most common type of heart disease in developed countries in Europe and America. In China, as in other developing countries, the incidence of coronary heart disease has been increasing significantly in recent years due to the improvement of living standards and lifestyle changes, with the average annual increase of myocardial infarction reaching 4.3%, resulting in more than 600,000 deaths per year. The number of patients with lung cancer combined with coronary artery disease is also increasing year by year. Overseas statistics for patients undergoing coronary artery surgery show that about 5% of coronary artery bypass patients have combined lung shadow, and another report shows that the incidence of lung cancer combined with myocardial ischemia is about 10%. Although there are no relevant statistics in China, we have observed clinically that the trend of increasing the number of such patients is also very obvious. 2.The treatment of lung cancer combined with severe coronary heart disease is a recognized clinical problem: the preferred treatment for lung cancer is surgical resection: lobectomy plus lymph node dissection. For patients with lung cancer combined with severe coronary heart disease, it is very difficult to formulate the surgical treatment plan. If staged surgery is adopted and lung cancer resection is performed first, the anesthesia and the damage caused to the organism during surgery as well as the compensatory process of the organism after surgery will induce myocardial ischemia, resulting in different degrees of decline in cardiac function, and severe ischemia may even lead to myocardial infarction and endanger life, so the prior lung resection surgery faces Cardiogenic surgery is very risky. If coronary artery bypass surgery (hereinafter referred to as coronary artery bypass) is chosen first to improve cardiac function and then wait for 3 months after surgery for the patient to recover before lung cancer resection, progression of lung cancer may occur during this waiting period thus reducing the surgical efficacy or even distant metastasis and losing the chance of surgical cure, and at the same time, two successive surgeries also increase the patient’s pain. In the early years, some doctors also chose to perform lung cancer resection and coronary artery bypass surgery at the same time, but the mortality rate of the surgery was more than 6%, because at that time, cardiac surgery including coronary artery bypass had to be performed under extracorporeal circulation, and complications such as bleeding and infection after surgery were the main causes of death during the same surgery. Therefore, clinically, most patients with lung cancer combined with severe coronary artery disease can only choose conservative treatment such as chemotherapy and radiotherapy, which have poor treatment effect and lose the chance of long-term survival. Lung cancer is the number one malignant tumor threatening human life, and surgical resection of lung cancer was carried out as early as the 1930s. The most important reason is the lack of effective means for early diagnosis of lung cancer. For patients with lung cancer combined with severe coronary artery disease, in order to remove lung cancer early and reduce intraoperative and postoperative cardiogenic complications, attempts of lung cancer resection and simultaneous cardiac surgery were carried out abroad as early as the 1970s, and some articles were published intermittently in the 1990s, with varying treatment results and a high operative mortality rate of about 6%. In 1995, Dr. Rivière et al. reported the largest group of simultaneous lung cancer and heart surgery cases to date, with a total of 79 patients, all operated under extracorporeal circulation, with an overall operative mortality rate of 6.3%. Most of the patients in the same surgery had lung cancer resected and lymph node dissection through a median incision. Although stage I lung cancer accounted for 67% and stage II for 23% of this large group of cases, the overall 5-year postoperative survival rate was only 42%, which was not a satisfactory result. Another important article was published by Dr. Miller on a controlled study of simultaneous and staged surgery for cardiac and lung cancer, in which all lung cancer resections in his simultaneous surgery group were done through a single median incision, but the 5-year survival rate for stage I lung cancer was equally poor at 36.5%. Therefore, Dr. Miller believes that lung cancer surgery through a single median incision is incomplete for mediastinal lymph node dissection due to exposure, which directly leads to inaccurate lung cancer staging and poor treatment outcome. There are also some articles that report that tumor patients operated under extracorporeal circulation resulted in extensive metastasis. Thus, it can be seen that earlier simultaneous surgery not only had high mortality rate and many complications but also had many controversies. Although theoretically simultaneous surgery has many advantages such as early treatment of lung cancer and coronary heart disease, pain relief and saving medical resources, it was not accepted by the majority of doctors and patients. In this century, due to the advancement of technology, especially with the application of non-stop coronary artery bypass technology, the risks and complications of coronary artery bypass surgery have been significantly reduced while avoiding extracorporeal circulation, and there are a few reports of simultaneous lung cancer and non-stop coronary artery bypass surgery in the international arena one after another. Lung cancer resection was performed through a median incision. Although the total number of surgical cases was small and scattered, it reflects that simultaneous surgery may still be the main treatment modality for patients with lung cancer combined with severe coronary artery disease in the future. Since 2003, we have been trying to perform simultaneous lung cancer resection and non-stop coronary artery bypass grafting by the cooperation of thoracic and cardiac surgeons, and have accumulated more clinical experience in patient selection, intraoperative techniques and perioperative patient management. One of the reasons is that lung cancer is resected through the lateral thoracic incision, which is the most familiar to thoracic surgeons, and the operation is fast and does not interfere with the heart. In recent years, to further reduce surgical trauma, we have also used a single median incision to complete the pneumonectomy, taking advantage of the intraoperative thoracoscope that can penetrate deep into the chest to observe dead spaces that are difficult to observe with the naked eye to ensure lymph node dissection. Preliminary concurrent surgical results have been published in the Chinese Medical Journal and the Chinese Journal of Thoracic and Cardiovascular Surgery. The safety of the surgery was consistent with foreign reports, with no cases of surgical death, but serious complications in individual cases, including one case of acute respiratory distress syndrome. Preliminary summary of our case data shows that there are many differences in case selection and surgical techniques from foreign literature, for example, foreign cases are relatively mild with 1-2 coronary artery bypasses, lung cancer are all stage I and II patients, most coronary artery bypasses are 3, and a few patients have stage IIIa lung cancer. 5. The safe development of simultaneous lung cancer and coronary artery bypass surgery has solved the clinical problems and has great significance and necessity: under the current dilemma of high incidence of lung cancer, increasing number of patients with severe coronary artery disease and insufficient clinical treatment measures, the new simultaneous surgery can provide the best treatment plan for lung cancer and coronary artery disease in accordance with the clinical diagnosis and treatment routine, and the surgery can complete the radical resection of tumor and improve the heart function at the same time. It is expected to provide a way out of the current clinical dilemma by prolonging the life of patients and improving their quality of life. The new lung cancer and coronary artery bypass surgery adopts the latest technology and combines new medical concepts, which is in line with the development of medicine and can promote the progress of related surgical procedures to a certain extent. The simultaneous lung cancer and heart surgeries can be completed at the same time during one hospitalization with one anesthesia, which can reduce the pain of patients’ second surgeries and at the same time reduce medical costs and save medical resources, which is in line with the current national trend of controlling the increasing medical costs and the whole society’s emphasis on saving and environmental protection.