The aim of this prospective study was to show the technique and results in a group of high-risk patients with multivessel disease treated with MINI-OPCAB operation LIMA to LAD and maximal medical treatment during the last 7 years in the Benetti Foundation.Material and Methods: The average age was 71.07 (ST D 9.051 CI 95%), 21% were females: The preoperative risk Logistic Euroscore was 10.68 (ST D 5.407 CI 95%). The patients were strictly followed monthly in the Clinic of the Foundation by the Heart Team. Surgical technique: the patient is prepared like for a normal sternotomy. The sternum is open at the intercostal space level 3 or 4. The left internal mammary artery is dissected around 8 cm. Anastomosis is made in a beating heart using a mechanical stabilizer. Statistics. Data were analyzed with the Statistical Package for Social Sciences (SPSS. Version 15.0). Results: The operative mortality was 0% in this group of patients. The incidence of perioperative infarction was 0%. MACE at 80 months was 0%. Survival at 7 years was 82% (K-M). Conclusions: We strongly believe that the combination of a MINI OPCAB operation and optimal medical treatment, in high risk patients, with multivessel coronary disease is a valuable option for this type of patients, although more experience is needed to confirm these initials results.