First surgical treatment for angina pectoris by performing sympathectomy was first proposed in 1899. Decades of experimental surgery for coronary artery disease (CAD) finally led to the introduction of coronary artery bypass grafting (CABG). In 1964 Vasilii Kolesov is believed to have been the first to perform a sutured anastomosis of an internal mammary artery (IMA) to left anterior descending artery (LAD). Rene´ Favaloro was the first to systematically perform CABG with reproducible Results.
　　Over the past fifty years, CABG has undergone many developments both technically and clinically. In 1994, minimally invasive CABG was introduced. In 2009, “SYNTAX”trial retainsed CABG as superior revascularization strategy in complex coronary disease. In 2011 “HEART”and“STITCH”trials dedicated comparing CABG with medical therapy for patient with severe left ventricle dysfunction. Even debate on stents or CABG for left main disease is now under study by latest “EXCEL” trial.
　　Beyond the surgical revascularization, CABG adds a mechanism of myocardial protection that explains its ability to prolong life. In this talk, we will present current improvement of CABG and the future prospects.