Abstract Objective To assess the value of real-time three-dimensional echocardiography (RT-3DE) in evaluating left ventricular (LV) systolic function in ischemic heart failure patients with apical aneurysm after percutaneous ventricular restoration(PVR). Methods Seven patients with anterior wall myocardial infarction complicated apical aneurysm were selected for implanting Parachute. Heart failure symptoms were evaluated using the NYHA class, functional exercise capacity was assessed through the six-minute walk test. LV ejection fraction(3D-EF), LV end diastolic volume(3D-EDV) , LV end systolic volume(3D-ESV) and the standard deviation(SD) and difference (Dif) of the time to the point with minimal systolic volume (Tmsv)in 16 and 12 segments adjusted by the R-R interval(Tmsv16-SD%, Tmsv16-Dif%, Tmsv12-SD%, Tmsv12-Dif%), that was the index of LV systolic synchrony, were measured by using RT-3DE before and 6 months after the operation. Results Post-procedure NYHA class reduced and six-minute walk test increased evidently compared to pre-procedure (P＜0.05). LV apical geometry recovered and LV systolic function(3D-EF, 3D-EDV and 3D-ESV) improved significantly after PVR(P＜0.05). The index of LV systolic synchrony, Tmsv16-SD% and Tmsv16-Dif% were reduced markedly compared to pre-procedure (all P＜0.05). Conclusions PVR was relatively safe and effective for apical aneurysm theraphy. RT-3DE can accurately evaluate LV systolic function and systolic synchrony after PVR.