Abstract Objective — to evaluate early result of myocardial revascularization combined with endarterectomy and other reconstructive procedures on the coronary arteries in patients with diffuse coronary disease. Material and methods. Coronary artery bypass grafting (CABG) combined with reconstructive procedures on the coronary arteries was made in 73 patients with diffuse coronary lesion for the period from January 2016 to December 2017. Coronary endarterectomy (CE) was performed in 100% of cases including CE from the right coronary artery in 41 (56.2%) patients and CE from the left anterior descending artery in 21 (28.8%) patients. Isolated patch repair of the coronary artery using autologous vein was applied in 4 (5.5%) patients. Stent-endarterectomy was required in 2 (2.7%) cases. Results. In-hospital mortality was 4.1% (n=3). The causes of death were perioperative myocardial infarction (n=1), sepsis and respiratory distress syndrome followed by multiple organ failure (n=2). Prolonged inotropic support in early postoperative period was required in 44 (60.3%) patients, 2 (2.7%) patients needed for intra-aortic balloon counterpulsation. Acute cerebrovascular accident occurred in 1 (1.4%) patient, post-hypoxic encephalopathy with subsequent complete regression of symptoms was observed in 11 (15.1%) patients. Prolonged ventilation was required in 10 (13.7%) patients and bleeding followed by resternotomy occurred in 1 (1.4%) patient. Conclusion. Precise surgical technique of CABG, adequate anticoagulant therapy, CE combined with various reconstructive procedures on the coronary arteries expand the possibilities of direct myocardial revascularization with a minimum number of lethal complications.