Aim To make retrospective study of the clinical value of OPCABG in 696 cases of high-risk patients with coronary heart disease. Methods 696 cases were divided into OPCABG and CABG groups.The preoperative data,mortality,the average EuroSCORE and the complication rate(including perioperative myocardial infarction,stroke,new atrial fibrillation,acute renal failure,respiratory insufficiency,etc.) were compared between two groups. Results According to surgical procedure,696 cases of high risk patients were divided into OPCABG groups and CABG groups.OPCABG group had 504 cases,EuroSCORE score 7.71 ± 1.27;CABG group had 192 patients EuroSCORE score 7.64 ± 1.33. The average distal anastomosis was 3.46±1.42.The complication rate was 27.9% and operative mortality was 4.31%.ICU time was 65.4±6.73 hours,tracheal intubation time 16.4±6.9 hours and average EuroSCORE 7.68±1.30.There was no statistical difference among the preoperative data of age,comorbidity,gender,heart function and EuroSCORE score between the two groups.The number of distal anastomosis,operation time,blood transfusion,drainage,ventilation time,intensive care,hospitalization time,operative mortality and complication rates(bleeding,acute renal Failure and respiratory insufficiency) between the OPCABG group and CABG group had statistically significant difference.Conclusions Avoiding cardiopulmonary bypass,OPCABG reduces the surgical risks in high riskpatients and the effect of treatment is satifactory.