Some controversies still exist on the optimal operative techniques and indications for resection of left ventricular aneurysm. We reviewed our ten years experience in surgical treament of 180 patients with antro-apical left ventircular eneurysm. Multivessel disease in 122 (68%) and isolated left anterior descending (LAD) disease in 58 (32%) patients were identified, 25 patients underwent aneurysmectomy alone and remaining 155 had aneurysmectomy with bypass. Average number of distal anastomosis was 2.2±1.1. A modified technique of lineer closure with reduction of longitudinal axis was used. In 72 (40%) op patients the excision of aneurysm was done under hypothermic fibrillation without aortic cross-clamping. LAD system was bypassed by using internal mammary artery (IMA) in 134 (74.4%) patients. In early stages of postoperative period 54.3% of the patients having a graft to the LAD system needed positive inotropic support. When no graft was placed to the LAD system the incidence increased to 63.4% 28% of the patients without having aortic cross-clamping during repair needed positive inotropic support. The mortality rate was 0.5 %. We conclude that lineer closure technique is effective as much as the others. LAD grafting with IMA and repair without using aortic cross-clamping improve survival and reduce mortality rates.