There are three main ways to treat coronary artery disease, namely drug therapy, heart stent intervention and coronary artery bypass surgery, each of which has its own advantages: although drug therapy cannot change the narrowing of blood vessels, it is the basis and important means of coronary artery disease treatment; stent placement is less invasive and can make the narrowed blood vessels become more open, but the risk of restenosis after stent placement is great; bypass surgery has the best effect, but the process is much more troublesome, and there is also a large surgical scar that gives patients an illusion of high risk. Bypass surgery is the most effective, but the process is much more complicated and there is a large surgical scar, which also gives patients the illusion of a high risk. According to the National Center for Health Statistics, nearly 2 million coronary heart disease patients in the United States need to receive bypass or stent treatment every year, and only about one-third of them undergo bypass surgery. So some people claim that “heart bypass” surgery will soon be retired from the history stage. In fact, the advantages of bypass surgery are irreplaceable. First, the advantage of long-term results. Restenosis rate has always been the biggest problem of interventional (stent) treatment, and about 30% of patients will have severe stenosis again after six months of heart stenting, even with drug-coated stents, the restenosis rate is about 5%, and they have to undergo stenting or bypass surgery again. The key to the treatment of patients with severe coronary artery disease, whether stenting or bypass surgery, is to ensure as much post-operative patency as possible and to release the complete degree of stenosis. The biggest advantage of coronary artery bypass surgery is exactly this, bypass surgery can well avoid short-term restenosis or obstruction, the long-term patency rate after 5 or even 10 years is still high, and fewer people need to reconstruct blood flow again —— “The longer the time, the more the advantages of bypass surgery can be reflected.” These two points are the biggest advantages of bypass surgery, which cannot be achieved by any current treatment. Second, the advantage of adapting to the condition. Not all patients with coronary artery disease are suitable for stenting. For example, in patients with diabetes, coronary artery lesions are generally diffuse, making it more difficult and risky to place a stent, and very easy for restenosis to occur. Surgical treatment (coronary artery bypass grafting) has broader indications, and for complex lesions, surgical coronary artery bypass surgery is still the best choice; another outstanding advantage of surgical bypass surgery is that it can completely treat 100% occluded coronary lesions. Third, the advantage of medical expenses. After stent placement, many drugs are needed to keep the stent open, and the cost of drugs is very high. In contrast, heart bypass surgery uses its own blood vessels, so you don’t have to worry too much about restenosis, and only ordinary medications are needed. Also, since stents themselves are still expensive, the cost of placing two or three stents is definitely higher than the cost of bypass surgery; not to mention the cost of repeated treatments. The results of a landmark international study have reaffirmed the irreplaceability of bypass surgery, a large clinical trial called SYNTAX, conducted in collaboration with 85 heart centers in Europe and the United States. The patients were then closely observed for recovery after treatment. Through a three-year clinical study, scientists found that major cardiovascular events such as heart attacks or strokes occurred in 28 percent of those treated with stents, and in some high-risk patients this rate was as high as 34.1 percent. This rate was as high as 34.1 percent in some high-risk patients, compared to 20.2 percent in patients treated with coronary artery bypass grafting. In addition, stenting within three years was associated with a 22% higher mortality rate and about twice the probability of myocardial infarction than bypass surgery; and one in five patients required repeat surgery compared to one in ten in the coronary bypass group. The study concluded that coronary artery bypass surgery is a more appropriate treatment for patients with coronary artery disease with left main stem lesions, three coronary artery lesions, combined diabetes, long lesions, and complex lesions. Coronary artery bypass surgery is also the only option for patients with poor cardiac function and other combined cardiac surgical diseases in addition to coronary artery disease, such as ventricular wall aneurysm and mitral regurgitation. With the development of medical technology, techniques such as hybridization, non-stop bypass, small incision, and thoracoscopic bypass have started to be used in practice, and the degree of trauma of bypass surgery has been greatly reduced. In the clinical setting, we should choose the most suitable treatment for the patient’s specific condition, not only focusing on the minimally invasive effect of stenting, but also ignoring the high restenosis rate and the economic burden caused by repeated treatment, and focusing on the patient’s specific condition. The most favorable long-term prognosis should be chosen.