Objective. Evaluation of comparative results of myocardial revascularization on the beating heart of patients with coronary artery disease who underwent operations through mini-accesses (ministernotomy and minithoracotomy).

Material and methods. A retrospective analysis of the results of surgical treatment of 66 patients with coronary artery disease belonging to the risk category for the 2015-2023 years was carried out. 32 patients (group 1) underwent coronary bypass surgery through a right-sided minithoractomy on a beating heart, and in 34 cases (group 2) the operation was performed from an inferior partial sternotomy on a beating heart. In both groups, male patients predominated (more than 80%). Age ranged from 55 to 75 years, the mean age was 63.2 + 2.1 years for both groups. The Euroscore scale averaged 2.75 in both groups, indicating that patients were considered to be at high risk for surgery. EchoCG before surgery in the first group looked as follows: average left ventricle end diastolic volume 175.5 + 48 ml, average ejection fraction – 45.8 + 5.1%. A left ventricular aneurysm was detected in 8 patients. In the second group: ejection fraction of left ventricle was 48,6+2,1%.

Results. The average number of bypasses was 2.8 and 1.5 per patient in both groups, respectively. The most complete bypass was performed in the minithoractomy group.

In the immediate postoperative period, perioperative AMI was not observed in both groups. The average period of stay at the intensive care unit in first group is 12 hours, in second group 11 hours.

62.5% of patients in the first group and 24.6% of patients in the second group needed inotropic support. Neurological complications were observed only in group 1 in 2.8% of patients. No in-hospital mortality was observed in either group.

Conclusions. Revascularization of the myocardium on beating heart of patients with coronary artery disease using mini-approaches allows: to avoid complications associated with the systemic pro-inflammatory reaction of the body, sternum infection and mediastinitis, reduce the duration of surgery and rehabilitation of patients. Operations performed by minithoractomy are more preferable due to the possibility of performing more complete revascularization of the myocardium.