Coronary heart disease, short for coronary atherosclerotic heart disease, is the “No. 1 killer” of human health, with about 2.6 million people dying from this disease every year, one every 12 seconds on average. The main means of treating coronary heart disease are drugs, interventions and surgical procedures. Among them, coronary artery bypass surgery (coronary artery bypass grafting) is internationally recognized as the most effective method for treating coronary heart disease, and has a history of nearly 50 years. The method of coronary artery bypass surgery is to take autologous blood vessels (often the saphenous vein and internal mammary artery) to establish a vascular pathway in the aorta and the distal end of the obstructed coronary artery (as shown in the figure) to ensure blood flow to the distal end of the coronary artery to meet the blood supply to the heart muscle and relieve the patient’s angina symptoms. The outstanding advantage of surgical bypass surgery is that it can completely treat 100% of occluded coronary lesions and requires less re-blooding. At present, most of the coronary artery bypass surgery can be done under general anesthesia, non-extracorporeal circulation and non-stop beating of the heart, which is less invasive, shorter hospital stay and quicker to resume normal activities. According to the condition of the player segment In the treatment of coronary artery disease, the choice between medication, intervention and surgery has to be evaluated by professional doctors. Medication is the basis, but it is difficult to reverse the existing atherosclerotic plaque and histomorphological changes of the vessel wall. Therefore, for those who have frequent angina attacks and the effect of medication is not satisfactory, interventional or surgical treatment should be chosen in time. Patients with multiple branch lesions, left main lesions, stent restenosis, combined with other structural heart disease, cardiac insufficiency, and high risk of bleeding will benefit more long-term from coronary artery bypass surgery than interventional treatment. Diabetic patients need to control sugar before and after bypass surgery. The incidence of coronary heart disease is two to four times higher in diabetic patients than in the normal population, and the onset of the disease is earlier and more severe. These patients can undergo bypass surgery, but the stress before and after surgery may lead to elevated blood glucose and induce acidosis, hyperosmolarity and electrolyte abnormalities. Therefore, these patients must have proper blood glucose control during the perioperative period. Bypass after heart attack should be early In the past, it was thought that it was difficult to endure surgical procedures within 30 days after acute heart attack. However, in recent years, experts have recognized that opening blocked vessels within 6 hours of acute myocardial infarction to provide myocardial reperfusion is of great significance in reducing the area of myocardial infarction and mortality. Acute coronary artery bypass grafting is feasible 8 hours to 16 days after acute infarction, with good cardiac function and small infarct size. Cautious bypass in patients with cerebrovascular disease Both coronary artery disease and cerebrovascular disease are the result of systemic atherosclerosis. Patients with acute infarction have poor cardiac function, the whole body blood supply and oxygenation are affected, and cerebral ischemia is prone to serious complications such as cerebral infarction – cerebrovascular events such as cerebral infarction or cerebral hemorrhage 3 months before surgery are contraindications to cardiac bypass surgery, and it is necessary to wait for the brain lesion to stabilize before bypass surgery. Quit smoking for two weeks before surgery Patients with coronary artery disease combined with chronic obstructive pulmonary disease (COPD) have an increased chance of postoperative lung infection and will spend more time in the ICU, increasing patient mortality. Such patients need to quit smoking for a minimum of two weeks (preferably two months) and perform respiratory function exercises before surgery. High-risk patients also need prophylactic antibiotics before surgery. It is important to maintain a good lifestyle and not to stop taking medications without your doctor’s approval. Patients after bypass or stenting need to eat a light diet and avoid overexertion, just like regular coronary patients. The use of anticoagulant drugs such as aspirin and Poliovel may cause bleeding, and patients need to observe any black stool and abdominal pain at all times; the use of lipid-lowering drugs may cause rhabdomyolysis and liver and kidney damage, and they need to be reviewed regularly to observe any muscle pain for timely treatment.