Aim: to improve perioperative management of high-risk patients with complicated forms of IHD. Materials: 156 high-risk patients with complicated IHD, admitted for surgical treatment. Results: retrospective analysis of patients’ data revealed aneurysm of the left ventricle in 17 (10.8%) patients, ischemic cardiomyopathy in 132 (84.6%) patients, and severe ischemic mitral insufficiency in 7 (4.4%) cases. All patients were at a very high risk of death according to ES II scale, risk stratification of the study group was 9.7%, while hospital mortality was 0%. Conclusion: cardiological support of patients as part of the heart-team is one of the important part of a positive result in cardiac surgery. Timely compensation of comorbid conditions helps to avoid complications and deaths.