An analysis, the shaping-up and perfection of the surgical treatment of ischemic heart disease (IHD) by using the method of small-invasion grafting of coronary arteries without applying the artificial bypass blood circulation is described. Indications and contraindications for the surgery of coronary grafting on the working heart and with minimal approach are discussed. Advantages of such surgeries boil down to a smaller trauma, a better cosmetic effect, milder pain, a quicker rehabilitation (with a shorter stay in hospital) and cost-efficiency.