Traditionally, coronary artery bypass grafting (also known as coronary artery bypass grafting) is performed in extracorporeal circulation, with the heart in arrest. This is because the heart is always beating, and the coronary arteries are only about 2 mm in diameter. It is difficult to perform such a delicate operation in a field that is in constant motion. Therefore, the only way to ensure a smooth bypass surgery is to stop the heart. During cardiac arrest, the heart is replaced by extracorporeal circulation, which drives blood circulation and is equivalent to an artificial heart. However, after all, extracorporeal circulation cannot fully simulate the function of the heart, and therefore, it may have a series of adverse effects on the body. Such as disrupting the coagulation function, increasing neurological complications, and inducing stress reactions in the body. With the advancement of technology and surgical devices, it has finally become possible to perform bypass grafting operations on a beating heart, thus giving rise to coronary artery bypass grafting under non-extracorporeal circulation (which we abbreviate as OPCAB). As the name suggests, the main difference between the two lies in the use of extracorporeal circulation or not. In the latter, the heart is always beating during the surgical operation, and the body’s blood circulation is completely governed by the heart; by abandoning extracorporeal circulation, the adverse effects associated with extracorporeal circulation are also avoided. Postoperative bleeding is likely to be less and neurological complications are reduced; patients recover faster, with shorter time off the ventilator, time in the monitoring unit and discharge time. In the last decade or so, OPCAB has become the routine bypass procedure. Admittedly, OPCAB shows superior technical advantages, but there is no denying that dancing over a beating heart requires more skill and experience. The inability of many large medical centers to perform OPCAB on patients with more complex conditions lies in the inability to guarantee the quality of the technique on the beating heart. The reason why we are able to guarantee more than 95% of the total number of bypasses performed during the same period is due to our deep commitment to OPCAB and our persistence in constantly refining our operating techniques over the years.