Coronary artery disease is a major cause of death worldwide. According to the American Heart Association updated in 2017, more than 360.000 deaths caused by coronary artery disease in the United States annually. Surgical coronary artery bypass grafting (CABG) is a revascularization procedure for patient with three vessel or left main coronary artery disease. Nearly 400.000 CABG were performed in United States annualy. CABG has been performed since 1950 and by the 1970s, nearly all CABG were performed using cardioplegia induced cardiac arrest and cardiopulmonary bypass machine. By the mid-1990s, off-pump CABG was introduced. The off-pump technique permitted surgeon to perform graft anastomoses on the beating heart without using cardiopulmonary bypass machine in order to avoid the inflammation responses and risk of the aortic manipulation. In 2002, nearly 25% of all coronary artery bypass grafting in United States were performed off-pump. Anesthesiologist plays important role to support the circulation during urgeonís manipulation, facilitating early recovery and discharge, reducing morbidity and mortality, and reducing procedural cost.