40 year old with history of congenital cleft tricuspid valve requiring tricuspid valve repair presenting for evaluation of heart function. Left VentricleThe left ventricle is moderately dilated with normal systolic function. The overall LV ejection fraction is 60%, the LV end diastolic volume index is 105 ml/m2 (normal range: 65+/-11), the LVEDV is 173 ml (normal range 109+/-23), the LV end systolic volume index is 42 ml/m2 (normal range 18+/-5), the LVESV is 69 ml (normal range 31+/-10), the LV mass index is 35 g/m2 (normal range 67+/-11), and the LV mass is 57 g (normal range 114+/-24). There are no regional wall motion abnormalities present. There is small area of late gadolinium enhancement in the mid inferior wall of unknown signficance. This was seen on previous CMR exams. This may represent a previous fibrosing, infiltrative, or inflammatory process.Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is severely dilated with normal systolic function. The overall RV ejection fraction is 52%, the RV end diastolic volume index is 133 ml/m2 (normal range 69+/-14), the RVEDV is 219 ml (normal range 110+/-24), the RV end systolic volume index is 63 ml/m2 (normal range 22+/-8), and the RVESV is 105 ml (normal range 35+/-13). Right AtriumThe right atrium is moderately dilated. Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is no significant mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThere is evidence of tricuspid valve repair. There is qualitatively moderate tricuspid regurgitation(appears slightly worse than previous study). AortaThere is a left sided aortic arch with a normal brachiocephalic branching pattern. The aortic root is normal in size.Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is normal in size. Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium. PericardiumThere is no obvious pericardial disease.Extracardiac FindingsSternal wires are noted. This study is not designed for the specific evaluation of extra-cardiac findings; therefore, the differentiation between artifacts and real extracardiac pathology may be difficult. If clinically indicated, a separate dedicated evaluation should be considered.
1. Moderate LV dilation with normal systolic function (LVEF 60%) with evidence of a small atypical pattern of late gadolinium enhancement seen in the basal inferior wall. 2. Severe RV dilation with normal systolic function (RVEF 52%).3. Moderate right atrial dilation.4. Moderate tricuspid regurgitation.When compared to the prior study, the patient's LV and RV are larger and the amount of tricuspid regurgitation is a little more. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.