From 2003 to 2004, 32 cases of elderly patients with coronary heart disease were admitted to our department. There were 30 cases of triple branch lesions, 3 cases of left main stem lesions, 12 cases of acute infarction, 17 cases of unstable angina, 9 cases of old infarction, 6 cases of ventricular wall aneurysm formation, 1 case of acute infarction combined with septal perforation cardiogenic shock, 1 case of severe aortic valve stenosis, and 1 case of severe mitral valve insufficiency. The ejection fraction of the left ventricle ranged from 36% to 76%, with an average of 53.9+10.0%, and the cardiac function was NYHA class 111 in 7 cases. There were 2 cases of preoperative persistent atrial fibrillation, 3 cases of stent restenosis, 1 case of combined esophageal cancer, 1 case of lung cancer, 1 case of abdominal aortic aneurysm, 6 cases of carotid artery stenosis (>50%), and 5 cases of severe aortic calcification suggested by CT. There were 14 cases of hypertension, 4 cases of chronic renal insufficiency, 9 cases of chronic obstructive pulmonary disease, 21 cases of diabetes mellitus, and 6 cases of old cerebral infarction. Patient characteristics: This group of patients had severe systemic atherosclerosis and diffuse coronary artery lesions. The incidence of hypertension, cerebrovascular accident, chronic obstructive pulmonary disease, severe aortic calcification, malignant tumor and peripheral vascular lesions was significantly higher than that of non-elderly patients in the same period. Preoperative carotid ultrasound and chest enhancement CT were routinely performed in this group of patients to understand carotid stenosis and calcification of the ascending aorta. No cerebrovascular accident occurred in this group of patients after surgery. Surgical characteristics: Compared with the data of bypass surgery in non-elderly patients during the same period, arterial bridge materials (left internal mammary artery and radial artery) were more common in non-elderly patients, while venous bridges were more frequent in elderly patients. Because the long-term patency rate of the left internal mammary artery bridge is significantly better than that of the saphenous vein bridge [1], the left internal mammary artery and anterior descending branch anastomosis were used in 78% of cases in this group. Considering emergency surgery, difficult to control diabetes mellitus, severe osteoporosis and chronic obstructive pulmonary disease, complete venous bridges were used in 7 cases. It is known that venous bridges are more prone to early onset of atherosclerosis. Usually venous bridges begin to show lesions 5 years after surgery, but venous bridge lesions are more likely to be treated with medical interventions and rarely require secondary surgical attic. In elderly patients, because of limited life expectancy, a better clinical outcome can be obtained by choosing the left internal mammary artery bridge for the anterior descending branch and the saphenous vein bridge for the other coronary arteries [3]. Although it has been reported in the literature that coronary artery bypass grafting with concomitant valve replacement surgery increases in-hospital mortality [4], if the valve lesion is of significant hemodynamic significance, valve replacement or angioplasty should be completed at the same time. If the valve lesion is not corrected at the time of coronary artery bypass grafting, residual valve lesions will have a negative impact on in-hospital mortality. A common cause of atrial fibrillation in the early postoperative period after CABG is volume deficit or electrolyte disturbance. Any new postoperative atrial fibrillation can be reversed with pharmacologic therapy. Because AF is a nonfatal postoperative complication, AF does not affect in-hospital or long-term mortality. The literature reports that age >75 years is considered as in-hospital mortality for congestive heart failure, preoperative atrial fibrillation, comorbid valvular disease, emergency surgery, and cardiogenic shock. The in-hospital mortality rate in this group was 0, similar to previous reports in the literature. Postoperative pump failure required IABP assistance, and cerebrovascular accident and respiratory failure were the main postoperative complications in elderly patients. Postoperative complications affecting long-term survival included low cardiac output, cerebrovascular accident, mediastinitis, pneumonia, prolonged mechanical ventilation, reintubation, and postoperative dialysis. Secondary open heart hemostasis, postoperative heart attack, and postoperative IABP implantation had no effect on long-term survival. The long-term mortality rate for bypass surgery in elderly patients was 9.3%, which was higher than in non-elderly patients (5.1%). Postoperative death from noncardiac causes was more common in elderly patients.