摘要冠状动脉旁路移植术是目前成人心脏外科最常见的手术。虽然静脉仍是目前应用最广的旁路移植材料，但利用左胸廓内动脉建立到左冠状动脉前降支的旁路已成为"金标准"，对年轻患者应争取使用更多的动脉旁路。体外循环心脏停跳旁路移植可以达到最好的完全心肌血运重建，对不适合胸骨正中切口和体外循环的高危患者，应合理选用非体外循环和各种微创旁路移植技术。采用术中旁路血流测定、术后"快通道"加速康复、强化药物治疗等综合手段，争取将手术风险降到最低，并获得最佳的中远期效果。尽管冠状动脉旁路移植术已经是成熟的外科手术，但仍需要设计更多的大型前瞻性多中心随机对照研究，为解决临床常见问题提供更多的循证医学证据。

abstractsCoronary artery bypass grafting (CABG), the most common heart surgery in adults, has been used clinically to relieve the angina and prolong patients life due to myocardial ischemia from coronary artery disease. Although the saphenous vein is still commonly used graft, it is the "golden standard" to bypass the left anterior descending artery with left internal thoracic artery, and more arterial grafts are recommended in young patients for better long term results. On-pump coronary bypass can get the most complete myocardial revascularization but off-pump and minimal invasive coronary bypass are better reserved for the patients who are not-suitable for mid sternotomy and cardiopulmonary bypass. Good quality control with flow meter during surgery, fast track post-operatively, and intensive anti-platelets therapy along with second prevention may further decrease perioperative mortality and increase long term grafts patency rate. In the field of CABG, more prospective multi-center randomized trials are needed to provide more evidences for clinical questions in order to get the best short-term and long-term results.