Remember what the angiogram looked like in patients with coronary artery disease a decade ago? Single branch, single, and even if multiple, diffuse lesions were rarely seen. The coronary arteries looked like tree roots. Most patients were in their 50s or 60s, had no liver or kidney insufficiency, rarely had associated mitral regurgitation, rarely had associated ventricular wall tumors, and had a left ventricular ejection fraction of at least 40%. Then look at the angiograms of today’s coronary patients ten years later: multiple lesions in multiple roots, diffuse lesions, and a mess of lesions in the intima after three or four stents were placed by intervention. The coronary arteries are all like camelia seedlings. Most of the patients were seventy to eighty years old, with acute and chronic renal failure, each with mitral regurgitation, and each with a left ventricular ejection fraction below 30%. What more to say, this is “coronary surgery in the era of drug stenting”! We tried total arterialization, we tried small incisions, we tried radial grafts, and when we studied in France, they tried MECC (mini CEC in French), robotic bypass (Da Vinci), and for the severely calcified ascending aorta, we tried Enclose and Heartstring. TMLR has been shot down by most cardiac surgeons, autologous stem cell transplantation has not yet been allowed to be widely used in the clinic, and stem cell transplantation can be done through interventional techniques. It seems we can still do a mitral valvuloplasty and ventricular wall tumor resection and molding at the same time as a bypass, so what else can we do? A heart transplant? Oh, is it that easy to get an access permit in China? Brain death has been officially approved and accepted by the public? Several advantages of coronary artery bypass grafting: high long-term patency, complete revascularization, left main stem lesions, and the ability to deal with infarct complications at the same time, have become so unbearable in the face of the rapid advances in interventional technology. With mitral valve shaping and aortic valve replacement, interventional techniques are already beginning to emerge. Live or die, it is time to think about the future of coronary surgery. Of course everything is also not yet so pessimistic. With the development of social and economic development, the standard of living increasingly improved, technology and equipment continue to update, the incidence and detection rate of coronary heart disease is also a significant upward trend. More and more cardiac surgeons are skilled in microscopic anastomosis, more and more scientific bypass equipment and techniques are being used, surgical teams are becoming more and more skilled, anesthesia and surgery times are becoming shorter, and the trauma and disturbance to the patient’s physiology is becoming less and less. Ultimately, it is the patients with coronary heart disease who benefit.