A true left ventricular aneurysm is a common complication of Acute Myocardial Infarction (AMI). It occurs after a transmural infarction as a result of gradual thinning and expansion of the scar wall of the left ventricle. Repeat heart surgeries in patients who have previously undergone aortocoronary bypass surgery are considered high-risk operations. Nine years ago, in 2014, the patient underwent CABG-CABG, and in 2021 an ICD was implanted. The patient was hospitalized in extremely serious condition. Over the past 3 days, the patient had frequent episodes of ventricular tachycardia, the ICD had triggered several times, and external electrical cardioversion had been performed multiple times since 23.02.2023. An echocardiogram revealed: chronic left ventricular aneurysm, massive thrombus in the left ventricle cavity, EF LV = 16%. A CT scan of the chest organs was performed considering the adhesion process due to the previous operation. Coronary angiography was performed: no significant stenoses in the coronary arteries. The venous shunt to the CABG is functioning well. Considering the life-threatening arrhythmias, massive LV thrombi, the decision was made by the board to surgically treat the patient. The operation of LV aneurysm repair according to the Dor procedure with thrombectomy from the LV + LV revascularization was performed on 24.02.2023. The duration of the operation was 144 minutes, aortic cross-clamp time was 106 minutes. Extubation was done 9 hours after the operation. The patient was discharged on the 10th day of hospitalization. At discharge, the LV ejection fraction was 33%. Six months after the operation, the LV ejection fraction was 40%. 

The treatment of true aneurysms is surgical intervention. True aneurysms may remain asymptomatic and be discovered during routine examinations; however, in some cases, patients may exhibit symptoms of heart failure, thromboembolism, or tachyarrhythmia, necessitating treatment upon each diagnosis.

Amirbek Shamshidinovich Midinov, born on April 14, 1985, is a skilled cardiovascular surgeon and PhD (Candidate of Medical Sciences) specializing in the surgical treatment of aortic valve diseases, particularly in obese patients. He has authored 46 published works, including 27 scientific articles, and defended his dissertation on “Ministernotomy in Surgical Treatment of Aortic Valve Diseases in Obese Patients.” He has completed his residency (2008–2010) and postgraduate studies (2011–2014) at the A.N. Bakulev Scientific Center of Cardiovascular Surgery in Moscow, where he also served as a cardiovascular surgeon from 2011 to 2021. Since 2021, he has been practicing at the Vedanta Medical Clinic (MBShM). He has actively participated in numerous national and international forums, including the XVI–XXIX All-Russian Congress of Cardiovascular Surgeons (2010–2023), the XV–XXV Annual Sessions of the A.N. Bakulev Center (2009–2023), the V All-Russian Congress of Transplantologists with International Participation (2010), the Russian-American Symposium on “Intensive Care in Cardiovascular Surgery” (2014), the Mirrahimov Readings (2022, 2023), the VI Annual Session of NIIHSTO dedicated to the memory of I.K. Akhunbaev (2023), and the International Scientific and Practical Conferences “V School of Arrhythmology” and “VI School of Arrhythmology” (2022, 2023) in Bishkek. Dr. Midinov remains deeply engaged in advancing cardiovascular surgical practices through both clinical excellence and ongoing academic contributions.