Myocardial ischemia is an important cause of coronary artery disease, and in clinical practice, coronary stenosis is a better major cause of myocardial ischemia, and most patients with myocardial ischemia also have coronary stenotic changes. Clinical coronary angiography reveals that many patients still have myocardial ischemic lesions although they do not have coronary stenosis. Therefore, there is confusion about whether to perform bypass surgery or not for myocardial ischemia. Coronary artery bypass surgery is to take a section of the autologous saphenous vein or other blood vessel located in the leg and bypass it between the aorta and the distal end of the blocked lesion of the coronary artery, so that blood from the aorta is supplied to the distal end of the coronary artery through the grafted vessel to restore the blood supply to the corresponding myocardium, improve the myocardial ischemic state and relieve the symptoms of angina pectoris. In simple terms, it is the creation of a channel between the proximal and distal coronary artery stenosis, and it usually takes only 6-7 minutes for a doctor to build a “bridge”. There are many advantages of this technique: 1, less trauma and faster recovery; 2, more than 30 years of clinical accumulation; 3, good long-term recovery after surgery, can maintain at least 10 years of patency. Indications: For patients with poor results of drug therapy and limited or staged stenosis of coronary arteries clearly identified by selective coronary angiography. Patients with myocardial ischemia, if the angiography finds that a coronary artery is occluded but the myocardium is not necrotic, it means that this part of the myocardium has a better collateral circulation, which theoretically corresponds to more than 90% stenosis of this vessel, such as increasing the myocardial demand for oxygen, such as exercise may induce angina pectoris or myocardial infarction, if conditions are feasible stent implantation or bypass surgery, if the occlusion time is not very long the vessel is likely to If the occlusion is not very long, the vessel may be opened, and the existing drug-coated stent, which has a low restenosis rate, may be considered, and if the vessel cannot be opened, bypass surgery may be considered. Drug therapy includes: antiplatelet drugs, nitrates, etc., which need to be adjusted according to the specific situation. Coronary stenosis is only one of the many factors leading to myocardial ischemia, and the possibility of myocardial ischemia should not be ruled out only based on the absence of stenosis in the coronary arteries, nor should the prevention and treatment of myocardial ischemia be based on improving coronary stenosis alone. Only comprehensive and holistic prevention and treatment measures can fundamentally eliminate the health hazards of myocardial ischemia. Therefore, the decision to bypass or not to bypass myocardial ischemia should be made carefully according to the doctor’s recommendation.