A 67-year-old female patient underwent a left ventricular aneurysmectomy and mitral valve replacement for ischemic cardiomyopathy. The replacement was done through left ventricle rather than left atrium. She had heart failure of NYHA class IV despite aggressive medical therapy. Preoperative examination revealed a left ventricular aneurysm and mitral regurgitation of grade II with markedly reduced ventricular function (LVEF 17%). Mitral valve replacement through left ventricle preserving chorda of the mitral valve is a promising method to eliminate regurgitation and shorten the cardiac ischemic time.