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6(0.7%)57(6.3%)65(7.2%)15(1.7%)619(68.6%)independent risk factors were obesity, dialysis, low left ventricular function, peripheral vascular disease, and stroke function (Table 4).New Challenges for CABG StrategiesBased on our experience, we believe that cere-brovascular disorders such as stroke after CABG should be prevented. Atrial fibrillation (AF) is a major cause of cerebral infarction, and it is known that 30% of patients develop transient postopera-106No. of patientsPOAFCerebrovascular accidentRespiratory complicationsRenal insufficiencyInfectionNo blood transfusionHospital stay (days)Hospital moratlityPOAF; postoperative atrial fibrillationTable 2　Operative results of primary isolated coronary artery bypass grafting at Juntendo UniversityFigure 5　Primary isolated coronary artery bypass grafting at Juntendo University Long-term results after coronary artery bypass graftingDM: patients with diabetes mellitus nonDM: patients without diabetes mellitusFigure 6　Primary isolated coronary artery bypass grafting at Juntendo University Long-term results in the follow-up of patients with renal dysfunction1984-19891990-1995787210(26.7%)21(2.7%)10(1.3%)9(1.1%)31(3.9%)390(49.6%)232(29.6%)32(4.1%)18(2.3%)38(4.8%)13(2.0%)364(46.3%)28±299(1.1%)1996-2001785688198(28.8%)17(2.5%)12(1.7%)54(7.8%)7(1.0%)356(51.7%)24±1416(2.0%)20＋137(1.0%)tive AF (POAF), even though the preoperative cases of AF are 2%. However, cardiovascular surgeons have not addressed this problem. There-fore, we believe that an immediate strategy for POAF is necessary. Furthermore, the addition of left atrial appendage (LAA) closure to the OPCAB for preventing cardiogenic stroke in the Emperor's surgery in 2012 was vital. The surgery results were excellent, and His Majesty the Emperor had lived a healthy 2002-20072008-2012931950191(20.5%)17(1.8%)132(14.2%)44(4.7%)19(2.0%)727(78.1%)309(32.5%)11(1.2%)52(5.5%)50(5.3%)23(2.4%)694(73.1%)11±712±147(0.7%)11(1.1%)GFR(ml/min/m2)G1G2G3G4G5GFR: glomerular filtration rate2013-2020902252(25.7%)13±1412(1.1%)>9060-8930-5915-29<15