An analysis was made of the operative results of 175 patients who underwent resection of chronic postinfarction left ventricular aneurysm, with or without associated cardiac surgery at Texas Heart Institute in one year period. The operative mortality was 11%. The surgical outcome of a subset of 96 patients was correlated with the indices of ventricular performance. Our findings indicate the risk of aneurismectomy is low for discrete aneurysm. Mortality and morbidity correlate significantly with total ejection fraction and our weighted scoring system as a determinant of left ventricular dysfunction. Total ejection fraction below 20% correlated with pump failure postoperatively, and total ejection fraction above 40% aided in predicting absence of pump failure. A total score above 20 correlated with pump failure and a total score below 20 supported prediction of absence of pump failure. Conversely, ejection fraction of the contractile part, percentage of perimeter involvement with left ventricular aneurysm and left ventricular end diastolic pressure were found to be poor predictors of surgical outcome.