Conventional on-pump coronary artery bypass grafting operations in patients with compromised left ventricular (LV) systolic function are accompanied by high rates of morbidity and mortality. The wide spread in the last two decades of off-pump myocardial revascularization techniques in patients with low surgical risk showed the safety of such operations. In this regard, the question of the possibility and results of such operations in patients with high risk, in particular, with low contractility of the LV, is especially actual. Aim - to study the results of off-pump myocardial revascularization operations in patients with LV ejection fraction (LVEF) less than 45 %%.