Ma Danyang, a 62-year-old woman, had a sudden onset of discomfort in the precordial region and upper abdomen and a feeling of suffocation a month and a half ago. The infarct was small in size, and after treatment, his condition gradually stabilized and he was able to take care of himself, but discomfort in the precordial region occurred when he ate a little more or was more active. Coronary angiography showed that all three major vessels of the heart had severe lesions. Among them, the middle segment of the anterior descending branch was completely occluded, the beginning of the obtuse marginal branch was 80% stenosed, and the middle segment of the right coronary and the posterior trigeminal anterior were 90% stenosed, so surgery was recommended. However, the preoperative ultrasound revealed that Ma had a congenital right kidney defect and a 3*4 cm cyst on the left kidney, which made the surgery risky. After a thorough understanding of the medical history and detailed preoperative examination, a comprehensive assessment of the condition was made and a decision was made to perform a non-extracorporeal circulation coronary artery bypass grafting. So three days after admission to the hospital, three bridges were made under general anesthesia with normal temperature heart beat. The postoperative recovery was smooth, with no abnormalities in renal function and complete disappearance of precordial discomfort after activity, and he was discharged 11 days after surgery. Comment: With the improvement of people’s living standard, there are more and more high-fat, high-protein and high-sugar components in the diet, coupled with reduced activity, there are more and more people who are obese, overweight, hyperlipidemic, diabetic and hypertensive. The number of people with coronary heart disease is increasing year by year, and the age of onset is getting younger and younger. At present, the emergence of coronary heart disease in the twenties is not a rare thing, but most coronary heart patients are still over 40 years old, mostly around 60 years old. When acute myocardial infarction occurs in coronary heart disease, the onset is rapid and dangerous, often causing life-threatening. With the development of medical technology, the mortality rate caused by acute myocardial infarction has decreased significantly, and the key lies in early diagnosis and timely treatment. Clinical studies clearly show that the time of myocardial reperfusion is the key to acute myocardial infarction, and the death rate is 1.6% for those with successful reperfusion within one hour of onset and 6% for those with successful reperfusion within 6 hours, which once again fully reflects the true meaning of time is life. Specifically to Ma Daniang, the precordial area was first treated as gastric disease, which has missed the best treatment time, fortunately the infarct area is small and non-transmural myocardial infarction, otherwise life is in danger. Myocardial infarction treatment at present mainly has three kinds of drug treatment, interventional stent and surgical bypass, each of which has its own indications, among which for coronary artery left trunk lesions, left trunk emitting major branch of the bifurcation lesions, multiple branches of multiple serious lesions, chronic occlusive lesions but the distal vessels are still good coronary heart patients, suitable for surgical bypass. The bypass is divided into two types: cardiac arrest and non-stop, of which non-stop requires higher technology, but less damage to the body, fewer complications, faster recovery, and higher safety, especially for the elderly. Specifically to Ma Danyang, such as the choice of cardiac arrest bypass, even if the bridge is very good, postoperative renal insufficiency or even failure, and the mortality rate of renal insufficiency or kidney failure after cardiac surgery is 50-70%. At present, the most advanced bypass method is non-extracorporeal circulation (i.e. cardiac non-stop) total arterialized coronary artery bypass grafting, which not only has the advantage of minimally invasive cardiac non-stop, but also has better long-term results.