Coronary artery bypass surgery is indicated for patients with angina pectoris, especially unstable angina pectoris, and for patients who have failed to respond to systemic drug therapy. It is also indicated for patients with coronary angiography suggestive of left main or multibranch lesions, or with stenosis of the high anterior descending and high gyral branches of the left main; limited stenosis of the main coronary artery with a diameter stenosis of 50% or more, with distal patency of the stenosis and a diameter greater than 1.5 mm. Coronary artery bypass grafting should be performed in cases of failed percutaneous transluminal coronary angioplasty (PTCA) or postoperative restenosis, bleeding due to penetration of the coronary artery during PTCA, or blockage of the distal lumen by plaque exfoliation, or significant stenosis after thrombolysis for acute myocardial infarction. Coronary artery bypass grafting is also suitable for patients with angina pectoris, abnormal origin of coronary artery and coronary artery fistula. Li Kezhi, Department of Thoracic and Neck Surgery, Nanping First Hospital Coronary artery bypass grafting also has contraindications, such as diffuse lesions in the coronary arteries, lesions with distal lumen diameter less than 1 mm or incompetence, chronic heart failure, severe pulmonary insufficiency, low left ventricular function (EF with hypertension or combined diabetes mellitus and renal insufficiency, whose symptoms cannot be controlled by drugs. When severe angina pectoris persists and the patient has severe adverse reactions to anti-myocardial ischemic drugs, the site of coronary artery lesion must be clearly identified by imaging so that the appropriate method of revascularization can be selected. When angina is controlled, a non-invasive test is required and coronary angiography should be performed if the results are “high risk”. After the anatomical lesion of the coronary artery is clearly identified, it is reasonable to choose the method of revascularization according to the following principles: 1. Single-branch lesion: For patients with a single-branch lesion that is clearly in need of revascularization and has a suitable site, endoluminal angioplasty or other catheter interventional techniques or minimally invasive bypass surgery is appropriate. 2. Multi-branch lesion: For patients with a double-branch lesion and no left heart insufficiency, endoluminal angioplasty and coronary artery bypass grafting are more effective in the long term. The long-term mortality rates for coronary artery bypass grafting and coronary artery bypass grafting are similar to the incidence of myocardial infarction, and angioplasty is a feasible option for initial treatment as long as the patient can accept the possibility of recurrence of symptoms and the need for reoperation in the future. Long-term outcomes of the procedure Coronary artery bypass surgery is very effective in relieving patients’ angina symptoms and improving cardiac function, and most patients have a relatively satisfactory quality of life after surgery. Some studies have demonstrated that 50% of patients are able to engage in moderate or vigorous activity 2-3 years after surgery. The 10-year patency rate is about 50-60% for venous bridges and 90 % for internal mammary arteries after coronary artery bypass surgery. According to the American College of Cardiology, the survival rates at 1 month, 1 year, 5 years, 10 years, and 15 years after surgery are 96.5%, 95%, 88%, 75%, and 60%, respectively. The reasons affecting postoperative survival are mainly due to occlusion of the graft and progression of the coronary artery disease itself, but also related to the degree and type of angina pectoris, the degree and extent of coronary artery disease, the status of cardiac function, the presence of diabetes mellitus, and pulmonary insufficiency of the patient before surgery.