28 year old male with history of Tetrology of Fallot s/p repair and PV replacement who presents for cardiac MRI to evaluate for right and left ventricular function and size Left VentricleThe left ventricle is upper limits of normal in size with mildly reduced systolic function. The overall LV ejection fraction is 45%, the LV end diastolic volume index is 105 ml/m2 (normal range: 74+/-15), the LVEDV is 193 ml (normal range 142+/-34), the LV end systolic volume index is 58 ml/m2 (normal range 25+/-9), the LVESV is 106 ml (normal range 47+/-19), the LV mass index is 44 g/m2 (normal range 85+/-15), and the LV mass is 80 g (normal range 164+/-36). There is global hypokinesis. Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is moderately increased in size with moderately reduced systolic function. The overall RV ejection fraction is 35%, the RV end diastolic volume index is 141 ml/m2 (normal range 82+/-16), the RVEDV is 260 ml (normal range 142+/-31), the RV end systolic volume index is 92 ml/m2 (normal range 31+/-9), and the RVESV is 168 ml (normal range 54+/-17).Right AtriumThe right atrium is normal in size.Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.The aortic valve is probably bicuspid in morphology; however, a good imaging plane was not able to be obtained when the patient was not having arrhythmia. Mitral ValveThe mitral valve opens widely and there is no significant mitral regurgitation.Pulmonic ValveThere is a bioprosthetic pulmonic valve present. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is mild tricuspid regurgitation.AortaThere is a right sided aortic arch with mirror image brachiocephalic branching pattern. The aortic root is dilated in size.Sinus of Valsalva: 48 x 36 mm (5/1/2014: 47 x 35 mm)Sinotubular junction: 35 x 33 mm (5/1/2014: 36 x 33 mm)Ascending Aorta: 29 x 32 mm (5/1/2014: 30 x 29 mm)Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is dilated in size. The LPA has a sharp angulated take off and is significantly narrowed at the ostium; however, there is no evidence of flow acceleration suggesting that the narrowing is not hemodynamically significant. Main pulmonary artery: 41 x 38 mm (5/1/2014: 39 x 38 mm)Right pulmonary artery: 24 x 23 mm (5/1/2014: 20 x 22 mm)Left pulmonary artery: smaller in caliber- 13 x 15 mm (5/1/2014: 16 x 15 mm)Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium.PericardiumThere is no obvious pericardial disease.Extracardiac FindingsThis 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. The left ventricle is upper limits of normal in size with mildly reduced systolic function [LVEF 45%]2. The right ventricle is moderately increased in size with moderately reduced systolic function [35%]3. Probably bicuspid aortic valve morphology3. Aortic root dilation with no evidence of aortic coarctation. No significant change from prior study.4. Pulmonary artery dilation with ostial left pulmonary artery stenosis.5. Bioprosthetic pulmonary valve present6. In comparison to the study performed 5/1/2014, there has been no significant change. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.