Abstract: Objective To investigate the effects of cardiopulmonary bypass（CPB）and off-circulation coronary artery bypass grafting（CABG）on visceral injury in elderly patients with coronary heart disease.Methods 144 elderly patients with coronary heart disease admitted in our hospital from July 2013 to June 2017 were divided into two groups：the control group（n=72）and the control group（n=72）treated with coronary artery bypass grafting（CCABG），）under cardiopulmonary bypass（CPB）.Off-pump coronary artery bypass grafting（OPCAB）was performed to compare the clinical indexes，complications，CK-MB，cTnI，（IO），kidney（BUN，SCr）of lung，liver（AST，ALT）and brain（S100B protein）injury between the two groups.The improvement of cardiac function（LVEF，LVEDD）was recorded 12 months after operation and the quality of life was evaluated with SF-36 scale.Results there was no significant difference in the operation time，the number of bypass grafts and the drainage volume within 24 hours after operation between the two groups（P>0.05）.The complications were significantly lower than those in the control group（P<0.05），and the protein of AST，ALT，BUN，CK-MB，SCr，cTn Igni S100B in the observation group was significantly lower than that in the control group at the end of operation（T2），24 hours（T3）and 48 hours（T4）after operation（P<0.05）.There was no significant difference in LVEF，LVEDD between the two groups at 12 months after operation（P>0.05）.The GH，RE，MH scores in the observation group were significantly higher than those in the control group（P<0.05）.Conclusion both CCABG and VOPCAB can cause visceral tissue injury in elderly patients with CHD.The degree of OPCAB injury to lung，myocardium，kidney，liver and craniocerebral tissue is smaller and the prognosis is better than that of CCABG.

Key words: Coronary artery bypass grafting, Coronary heart disease, Off-pump, Organ injury