Long-term follow-up of a consecutive 333 patients who underwent coronary artery operations from 1974 through December of 1982 is reported. The surgical procedures in this series consisted of aortocoronary bypass grafting for angina pectoris in 269 patients (Group I), various operations for myocardial infarction and its mechanical complications in 44 patients (Group II), and combined operative procedures in 20 patients (Group III). The 5 year survival rate of Group I, Group II and Group III were 92.9% 72.7% and 80% respectively. Nine out of 14 late deaths in the whole group were not related cardiac deaths. Sixty eight patients with aorto coronary bypass grafting were asymptomatic and 27% were less symptomatic in the long term periods. The postoperative study indicates that aorto coronary bypass grafting increased coronary blood flow estimated by regional coronary venous flow associated with improvement of left ventricular function and myocardial metabolism resulting in so called "better quality of life". The successful aorto-coronary bypass grafting prevented the incidence of myocardial infarction at the time of subsequent combined vascular or malignant operation in the same individuals. Although the early death was somewhat high in the patients with acute myocardial infarction, the patients who survived the operation had the satisfactory long term results.