Introduction

Left ventricular (LV) aneurysms result from large transmural myocardial infarctions (MI).[1],[2] Historical estimates suggest aneurysms occur in a third of patients with Q-wave infarctions. In the contemporary era, the incidence is significantly lower due to improved time to coronary revascularization and optimal medical therapy. True LV aneurysms are made of fibrous scar tissue, a property that makes them less vulnerable to rupture yet still leads to a maladaptive process characterized by adverse ventricular remodeling and a progressive decline in LV function. Surgical therapy initially focused on aneurysmectomy; however, management has since evolved to address the tenets of the diseased vessel, valvular abnormalities, and ventricle. Patient selection is paramount to the success of surgical therapy for LV aneurysms.