Abstract Aim — to present the results of treatment of patients with diffuse left anterior descending (LAD) coronary artery disease. Material and methods. There were 57 patients for the period February 2013 — June 2017. Thirty-seven of them underwent coronary artery bypass grafting of left anterior descending artery using internal mammary artery with patch angioplasty. Endarterectomy from left anterior descending artery followed by patch angioplasty was required in 20 patients. Mean follow-up was 1206 patient-months. Computed tomography was performed in order to assess log-term graft patency. Results. Five-year postoperative survival was 100% in coronary endarterectomy group and 94.5% in group of patch angioplasty. No perioperative myocardial infarction was observed in both groups. ST segment elevation or depression was detected in 3 patients. Mean level of creatine phosphokinase MB in blood was 23.5±8.3 U/L in coronary endarterectomy group and 22.5±6.5 U/L in angioplasty group. No patient required intra-aortic balloon counterpulsation. Inotropic and vasopressor support during the first day after surgery was required for almost 1/4 patients in both groups (24 and 25%; p=ns). Increased LV ejection fraction after intervention compared to the baseline values was observed in both groups. According to computed tomography data, patency of the grafts to LAD was 95%. Mid-term freedom from angina pectoris, as well as freedom from repeated coronary interventions were 91 and 93%, respectively (p=0.48 and p=0.37, respectively). Conclusion. Coronary endarterectomy or patch angioplasty in patients with diffuse coronary disease enable full myocardial revascularization with good early and mid-term postoperative results.