Clinical Data From August 1997 to March 2002, a total of 113 patients with coronary artery bypass grafting had left ventricular wall aneurysm resection surgery performed at the same time in the cardiac surgery department of a hospital. Among them, 104 cases were male, accounting for 92%; 9 cases were female, accounting for 8%. The mean age of the patients was 57.17±9.07 years old and ranged from twenty-six to seventy-one years old. All patients underwent coronary angiography and left ventriculography. The diagnosis of true ventricular wall aneurysm was based on the fact that the non-systolic part of the left ventricle wall was bulging outward at both end-systole and end-diastole. If the stenosis of the main branches of the coronary artery was greater than 75%, bypass bypass surgery was performed at the same time. The whole group of patients had a history of hypertension in 43 cases (38%); ventricular arrhythmia in 11 cases (9%); diabetes mellitus in 24 cases (21%); and angina pectoris in 73 cases (65%). Preoperative cardiac function: 27% of the patients had class IV cardiac function before surgery (30 cases); 36% of the patients had class III (41 cases) and 37% of the patients had class II (42 cases). Cardiac ejection fraction: The mean cardiac ejection fraction of patients before surgery was 46.70±8.94% twenty-six to sixty-four percent. Surgical methods All patients were operated under hypothermic extracorporeal circulation. Myocardial protection was performed first with cold potassium arresting fluid and later partially with cold blood arresting fluid. Transaortic root perfusion was used in 102 cases; retrograde perfusion via coronary sinus in 4 cases; positive perfusion combined with retrograde perfusion in 7 cases. After establishment of extracorporeal circulation, the pre-bypass target vessels and ventricular wall tumors were explored. Do not move the heart excessively in patients suspected of having appendage thrombus to avoid dislodging the thrombus and causing tethering of the arterial system. Pre-bypass target vessels are marked for localization. After the ascending aorta is blocked, the fibrous scar wall is incised along the long axis of the ventricular wall aneurysm at its most bookish point. Both sides are retracted with pulling hooks, and if there is an attached wall thrombus, a gauze block is placed at the aortic and mitral valve orifices to avoid thrombus entry into the aorta or left atrium before freeing the thrombus. The endocardial surface of the ventricular wall tumor and the mechanized thrombus within the myocardial trabeculae are carefully stripped and the heart cavity is flushed. When trimming the wall of the tumor, the extent of resection is determined from the outside boundary of the ventricular wall tumor as well as the boundary within the heart cavity. If the lesion involves the papillary muscle, a shimmed suture is required to fix the papillary muscle to the left ventricular wall; mitral valvuloplasty is performed in cases of moderate or greater mitral valve closure insufficiency. The peripheral tough fibrous wall is left in place for approximately 1.5 cm. For a prelinear “sandwich” closure of the ventricular wall tumor incision, an internal purse-string suture is placed between the normal myocardial tissue and the fibrous scar wall with 2 to 0 Prolene non-invasive sutures. Two felt pads are then placed longitudinally on either side of the incision and closed with continuous mattress sutures using large needle 2 to 0 Prolene sutures. A final reinforcing suture was placed with a No. 1 Daxon suture. For giant ventricular wall tumors and posterior inferior ventricular wall tumors the patching method was used. That is, an internal loading suture is first performed with 2 to 0 prolene, and the internal diameter of the left ventricular cavity is estimated. Appropriately sized polyester sheets are cut and lined with autologous pericardium. A circular strip of felt spacer is first placed on the outside of the ventricular wall defect. Using a 2 to 0 Prolene stitch, a needle is inserted from the outside of the felt pad, through the edge of the defect, and out through the polyester sheet at the inner edge, with interrupted or continuous mattress sutures. It is then reinforced with continuous sutures of 2 to 0 Prolene along the edges of the spacer and ventricular wall defect. In patients with septal perforation, we cut the polyester sheet into appropriately sized semicircles and perform septal repair by the single or double-piece method. For the single-piece method of repair, interrupted mattress sutures are placed with 3 to 0 Prolene stitches with a small spacer through the right side of the septum and tied through the straight edge of the septal patch. For the two-piece repair, an identical semicircular polyester patch is added to the single-piece method, also with a 3 to 0 Prolene stitch interrupted with a mattress stitch, with a small shim feeding through the left side of the septum and passing through the straight edge of the septal patch and tied. A felt spacer is then applied, and both edges of the ventricular wall incision are sutured together with the free edge of the septal patch using either continuous or interrupted mattress sutures; this is reinforced with another continuous suture. When performing bypass surgery, the proximal anastomosis is performed by opening the ascending aorta, clamping the lateral wall clamp, and then performing the proximal anastomosis. Tricuspid valvuloplasty is performed with the heart beating. A right heart floating catheter is routinely placed preoperatively in critically ill patients. Six cases (5%) had ventriculotomy alone; 33 cases (29%) had a triple-branch bridge; 40 cases (35%) had a two-branch bridge; and 34 cases (30%) had a one-branch bridge during the same period. The ventricular septal perforation was repaired in 5 cases (4%), and two of them were combined with severe tricuspid regurgitation and underwent tricuspid de vega angioplasty. The distribution of ventricular wall tumors was as follows: 97 cases were in the anterior wall and apical region alone; 12 cases were in the lateral wall; 2 cases were in the posterior inferior wall; and 2 cases were in the posterior inferior wall alone. Ventricular wall tumor size: mean area 59.26±25.17 cm2. Surgical outcome Seven patients died within 30 days after surgery, with a surgical mortality rate of 6.19%. Two patients with combined ventricular septal perforation, with preoperative circulatory instability and emergency resuscitation surgery, died postoperatively from low cardiac output and multiorgan failure. Another patient with a 4 cm × 4 cm septal perforation and severe tricuspid valve insufficiency underwent septal reconstruction, tricuspid valvuloplasty, bifurcation and aortic root reinforcement in addition to ventricular wall tumor resection, and the operation was successful; however, the patient died on the fifth postoperative day after extubation due to hemorrhage caused by a dramatic decrease in platelets. Two cases died of renal failure. The other two died from brain complications. The majority of patients had improved cardiac function after surgery. Of the 106 patients who survived the surgery, 64 were followed up, with a follow-up rate of 60.4%. Among them, 6 patients (9.4%) had class III cardiac function, 18 patients (28.1%) had class II cardiac function and 40 patients (62.5%) had class I cardiac function. 14 of the 64 patients were followed up for ejection fraction.