Background: Cardiac ischemic time reduction and myocardium protection can be achieved by warm blood perfusion into arterial or venous grafts during proximal anastomosis construction in coronary artery bypass graft (CABG) as off-pump surgeries. However, there is few previous on-pump CABG surgery studies of the impact of warm arterial blood primary graft perfusion. Objective: Our study aimed to investigate the positive benefits of warm arterial blood perfusion of grafted ischemic myocardial segments (through venous or arterial grafts during proximal graft anastomosis creation) on myocardium preservation. Patients and Methods: One hundred and twenty patients were submitted to coronary artery bypass graft (CABG) as on-pump surgeries involving proximal graft anastomosis. They were allocated randomly into two equal groups. Group A undergone aortic root antegrade hotshot infusion. While in group B, the additional warm arterial blood bypass graft perfusion was performed before cross- clamp removal, followed by proximal anastomosis, which had been accomplished using partial aortic clamp. Results: The requirement for the inotropic support and defibrillation throughout cardiopulmonary bypass (CPB) separation, total CPB duration inotropic support, IABP use, postoperative AF and MI as well as ICU and hospital stay were considerably lesser in group B when compared to group A. Conclusion: As summarizing, there was a significant myocardium recovery impact from the addition of antegrade direct bypass graft perfusion to aortic root warm blood hotshot throughout proximal graft anastomosis during on pump CABG.