Abstract: Objective To investigate the safety of surgical therapy and perioperative management of coronary heart disease patients over 70 years old. Methods The coronary artery bypass grafting (CABG) was performed in twenty-seven patients aged over 70 years old in the Department of Cardiac Surgery of the First Affiliated Hospital of Bengbu Medical College between October 2015 and December 2017. The clinical data such as complications, preoperative preparation, surgical procedure, operation time, postoperative ICU monitoring time, hospitalization time, postoperative complications and mortality were reviewed. Results The aortic valve blocking time was (106.32±45.25) min, extracorporeal circulation time was (164.95±52.43) min, the postoperative tracheal intubation time was (15.8±1.6) h, and the number of transplanted blood vessels was 2.8±0.8, the stay time in ICU after the surgery was (45.3±38.5) h, the Hospitalization time (35.45±6.3) d. The intra-aortic balloon pump (IABP) was used in 2 patients.One died from the low cardiac output, acute renal failure and pulmonary infection after coronary artery bypass graft surgery. The total number of early postoperative complications was 10 times in the group, including 2 cases of postoperative low cardiac output syndrome, 1 case of malignant arrhythmia, 1 case of postoperative acute renal insufficiency, 1 case of wound infection, and 2 cases of rethoracotomy, 2 cases of severe pulmonary infection, and 1 case of cerebrovascular event. Conclusion The surgical risk in coronary heart disease patients aged over 70 years old is high, and the patients are usually with a poor postoperative recovery. However, the surgical procedure is safe and feasible under the preoperative preparation, corresponding surgical treatment, strict postoperative monitoring and comprehensive treatment, and has a positive therapeutic significance.