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Aim. To assess safety and efficacy of minimally invasive myocardial revascularization (MIMR) in coronary heart disease (CHD) patients with left coronary artery (LCA) trunk pathology. Material and methods. Forty-six CHD patients (41 males, 5 females) with LCA trunk pathology, who underwent offpump coronary aortic bypass graft (CABG) surgery, were examined. Mean age of the patients was 58.7±2.5 years, mean CHD duration – 53.9±11.3 months. Results. Off-Pump Coronary Artery Bypass surgery is effective in CHD patients with LCA trunk pathology. It provides good results during in-hospital treatment, and is associated with low intra-operational risks. Conclusion. CHD patients with LCA trunk pathology require special attention at all levels of treatment. MIMR is effective and safe in this category of patients. It gives an opportunity to decrease CABG traumatic effects and is prospective for both patients and surgeons.