Heart bypass surgery, commonly known as coronary artery bypass, is a coronary artery bypass graft or heart bypass procedure performed when one or more of the coronary arteries are severely blocked or have a very inadequate blood supply. A thorough examination should be performed prior to surgery to confirm the exact site of the blockage. Coronary artery bypass surgery is an open heart surgery. The procedure will be performed in two parts, one for the heart itself and the other for the leg bypass vessel. The bypass vessel will be bridged over the blocked area of the coronary artery to restore blood supply to the heart muscle. Patients with coronary artery disease with the following lesion characteristics should opt for bypass. Left trunk lesions: According to national and international guidelines, surgery is the first choice for left trunk lesions. This is because left main stem can be fatal in the event of blockage or restenosis. To minimize the risk, bypass is the best choice. Three-branch lesion: The lesion has more vessels, and if interventional treatment is chosen, many stents have to be placed, which will greatly increase the chances of restenosis and thrombosis. Moreover, the financial burden on the patient is higher. Patients with cardiac insufficiency: These patients need complete hemodynamic reconstruction to promote the recovery of ischemic myocardium, which is difficult to do with interventions. Patients with diabetes mellitus: Normal stents have a high restenosis rate in diabetic patients, while pharmacological stents have been introduced for a short period of time, and there is no clear evidence that interventional treatment will have better efficacy than bypass. Patients with post-coronary myocardial infarction complications: ventricular rupture, septal perforation, and mitral valve closure insufficiency must be treated with surgical bypass surgery as an option.