It was performed the analysis of safety, efficiency, causes of unsatisfactory results, as well as optimization of strategy and tactics of direct myocardial revascularization performed by using of the sequential coronary artery bypass grafting. The study included 110 patients with coronary artery disease, which were divided into two groups: the group of sequential grafting (group I, n=55) and control group (group II, n=55). It was performed an assessment of the clinical condition, the frequency of cardiovascular complications was defined. Also sequential grafts patency was studied in the operated patients on the hospital stage and in long-term period. It was determined that sequential coronary artery bypass grafting is effective and safety method. It does not impair short-term and long-term results of direct myocardial revascularization. The value of the target coronary artery stenosis is important factor determining the patency of sequential coronary bypass grafts.