Coronary heart disease (coronary atherosclerotic heart disease) is a common and frequent disease of the cardiovascular system. With the change of lifestyle, the incidence of coronary heart disease in China also continues to increase. It has become the most common cardiovascular disease in China. Coronary artery bypass grafting is one of the main methods to treat coronary heart disease, using autologous vessels in the aorta and coronary can manifest as angina pectoris, myocardial infarction and sudden death, the distal end of the stenosis of the cardiovascular surgery department Xu Huashan of the First Affiliated Hospital of Zhengzhou University to establish a vascular bypass. There are three main means of treating coronary artery disease, namely drug therapy, coronary artery bypass graft surgery (CABG) and percutaneous intervention (PCI). Drug therapy is the basis of coronary artery disease treatment, but when atheromatous plaque formation leads to irreversible stenosis, drugs cannot do the recanalization of coronary arteries, and people began to seek ways to deliver blood to coronary arteries again. The world’s first recognized successful coronary artery bypass surgery was performed by Russian cardiac surgeon Kolessov in 1964. Since then, bypass surgery has evolved from intravenous bypass to full arterial bypass, from stop-beat bypass to non-stop bypass, from large incision with median sternal split to minimally invasive bypass, and has become an important treatment for coronary artery disease with a 10-year patency rate of over 50% for intravenous bypass and over 90% for arterial bypass. Another technique, interventional therapy, emerged in 1977, with the first case done by a German-Swiss doctor. In 2000, drug-eluting stents were used in clinical practice, and by adhering rapamycin or paclitaxel to the metal stents, they were used to inhibit intimal hyperplasia and thus reduce the stenosis rate. In 2007 alone, 150,000 coronary heart disease interventions were completed in China, with stenting accounting for the majority of cases. According to the U.S. National Center for Health Statistics, there are currently 1.3 million patients receiving stent treatment in the U.S. each year, while 448,000 people receive bypass surgery. Interventional treatment is less invasive, and patients can often be discharged within three days and return to work in a few days. Out of fear of surgical trauma, more and more patients are choosing stenting, but it has also led to stent abuse. Some patients have had dozens or even dozens of stents put in, resulting in a recurrence of the disease requiring bypass surgery when there is no place to put the needle; or patients with three vessel lesions requiring surgical treatment are inoperable because a stent has been put in. Once upon a time, there was no evidence as to whether interventions could really compare to bypass surgery; now, with the release of the results of the three-year clinical study of the SYNTAX large clinical trial (which included a total of 1,800 cases from 85 cardiac centers in Europe and the United States), the results of CABG versus PCI provide some basis for physicians’ future practice. It is also the first study to directly compare drug stents with bypass surgery. The SYNTAX study, which is now up to three years of follow-up, showed that 28% of patients treated with stents had a major cardiovascular or cerebrovascular event such as a heart attack or stroke, and in high-risk patients, this rate even reached 34.1%. In contrast, patients treated with bypass had only a 20.2% probability of having the same event. In addition, the stent-treated group had a 22% higher mortality rate over three years than the surgically treated group, was about twice as likely to have a myocardial infarction, and one in five patients needed to undergo surgery again, compared to one in ten in the bypass group. This study reaffirms that bypass surgery is a more appropriate treatment for patients with left main stem lesions, three branch lesions, combined diabetes, long lesions, and complex lesions. Bypass surgery is also an option for patients with poor cardiac function and other comorbid cardiac surgical conditions in addition to coronary artery disease. The SYNTAX trial will continue to follow these patients into their fifth year, and the advantage of bypass surgery is long-term patency after 5 or even 10 years. In an interview with the Los Angeles Times, Dr. Michael Mack, first vice president of the American College of Thoracic Surgeons, said, “Every time you compare bypass surgery to intervention, you see that the longer it takes, the more the advantages of the surgery become apparent.” And with the development of minimally invasive techniques, non-stop bypass, small incisions, and thoracoscopic bypass can reduce post-operative hospitalization days for bypass surgery to days, and patients can return to work weeks later with a level of trauma that has been greatly reduced, while the results of the procedure remain the same. When choosing a treatment modality for coronary artery disease, one should not only focus on the minimally invasive nature of the intervention and ignore the high restenosis rate and the financial burden of repeated treatments, but also choose the modality that is most beneficial to the long-term prognosis of the patient.