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4) Use in patients with chronic kidney disease: innovations in revascularization, especially for dialysis patients5) Prevention and management of POAF6) Freedom from cerebral infarction in the periop-7) Approaches to POAF2) Prevention of long-term cardiac events: the use 3) A new concept for diabetic patients: Prevention of infection and improvement of prognosis in the long-term follow-upbral blood vessels. Furthermore, neurologists, cardi-ologists, and hemodialysis physicians have different thoughts on anticoagulation medication than hemo-dialysis patients, making it challenging to continue medical therapy45, 46). Based on this evidence, we believe that aggressive intervention is necessary for LAA in dialysis patients.Conclusion and Future Perspectives. The following is a summary of the treatment methods we have been practicing for patients with ischemic heart disease.1) Introduction of OPCAB as a minimally invasive procedure: making OPCAB a standard surgical procedureof multiple arterial grafts Figure 11　1 Resection of Marshall ligament in ganglionated plexus(GP)A PA: pulmonary artery LUPV: left upper pulmonary vein Blue arrow is Marshall ligament.B The microscopic photo of resected Marshall ligament. Black arrow is the ganglion and sympathetic nerve fibers.erative and lasting lifetimeWe have continued to devise and improve on these goals for 20 years and have established the Juntendo surgical method today as the standard surgical method in Japan. We will continue to improve long-term outcomes for patients with long-term ischemic heart disease, preventing cardiogenic stroke as our most important target. Furthermore, if advances in imaging allow artificial intelligence to predict long-term outcomes, graft selection and LAA management will be more effi-cient for all surgeons.I have upheld two mottos throughout my profes-sional career: “一途一心,” to do what we can do in a 111