59 year old female, with a history of congenital heart disease, s/p tetralogy of Fallot repair, s/p bioprosthetic pulmonary valve replacement. She is referred for cardiac MRI for follow-up evaluation. Left VentriclePostsurgical findings compatible with tetralogy of Fallot repair.The left ventricle is normal in size and systolic function. The overall LV ejection fraction is 59%, the LV end diastolic volume index is 61 ml/m2 (normal range: 65+/-11), the LVEDV is 117 ml (normal range 109+/-23), the LV end systolic volume index is 25 ml/m2 (normal range 18+/-5), the LVESV is 69 ml (normal range 31+/-10), the LV mass index is 34 g/m2 (normal range 67+/-11), and the LV mass is 66 g (normal range 114+/-24). There are no regional wall motion abnormalities present. There is borderline flattening of the interventricular septum noted at end-diastolic phase, in retrospectively similar to prior cardiac MRI on 12/24/12 This might be indicative of a mixture of elevated right ventricular volume and pressure overload. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.No intracardiac thrombus.Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is mildly dilated with mildly reduced systolic dysfunction. The overall RV ejection fraction is 42%, the RV end diastolic volume index is 107 ml/m2 (normal range 69+/-14), the RVEDV is 206 ml (normal range 110+/-24), the RV end systolic volume index is 65 ml/m2 (normal range 22+/-8), and the RVESV is 124 ml (normal range 35+/-13). There is apical hypokinesis, unchanged.Right AtriumThe right atrium is normal. 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 ValveThere is a bioprosthetic valve in the pulmonic location generating susceptibility artifact. No significant pulmonic insufficiency was noted.Tricuspid ValveThe tricuspid valve opens widely. There is no significant tricuspid regurgitation.AortaThe ascending thoracic aorta is normal in size. There is a left sided aortic arch. Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is moderately dilated as 40 mm, which is stable from prior study.Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium. PericardiumThere is no pericardial effusion.Extracardiac FindingsThere is a 10mm right breast nodule located right of the nipple. This is unchanged compared to prior exam. No mammograms are noted in this PACS. Correlation with physical examination and mammogram is recommended. Small hiatal hernia is noted.
1. The left ventricle is normal in size and systolic function. The overall LV ejection fraction is 59%.2. The right ventricle is mildly dilated with mildly reduced systolic dysfunction.3. Postsurgical findings of repaired Tetralogy of Fallot. There is a bioprosthetic valve in the pulmonic location with stable caliber of the pulmonary artery. No significant pulmonic insufficiency was noted.4. Stable right breast nodule since last MRI; correlation with physical exam and mammography is recommended. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.