16 year old female with tetralogy of Fallot s/p repair (transannular patch) and RV to PA conduit, pulmonic valve replacement x2 with last one being a homograft, Left VentricleThe left ventricle is mildly dilated with mildly reduced systolic function. The overall LV ejection fraction is 45%, the LV end diastolic volume index is 90 ml/m2 (normal range: 65+/-11), the LVEDV is 207 ml (normal range 109+/-23), the LV end systolic volume index is 50 ml/m2 (normal range 18+/-5), the LVESV is 114 ml (normal range 31+/-10). There is global hypokinesis. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is mildly dilated with mildly reduced systolic function. The RV shape is elongated. The overall RV ejection fraction is 44%, the RV end diastolic volume index is 103 ml/m2 (normal range 69+/-14), the RVEDV is 237 ml (normal range 110+/-24), the RV end systolic volume index is 58 ml/m2 (normal range 22+/-8), and the RVESV is 134 ml (normal range 35+/-13). The right ventricular outflow tract is aneurysmal with evidence of a patch. Right AtriumThe right atrium is mildly dilated. Aortic ValveThe aortic valve is trileaflet, opens widely and there is mild aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is mild mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is mild pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is moderate tricuspid regurgitation.AortaThere is a left sided aortic arch with a bovine-style brachiocephalic branching pattern. The aortic root is normal in size but with clockwise rotation of the root and the coronary origins. Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThere is PA conduit. The proximal portion is normal in size (21x18mm). Distally, there is a narrowing (14x17mm) which extends into the left pulmonary artery (13x12mm) with evidence of flow acceleration. The right pulmonary artery is normal in size (21x17mm).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 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. Mild left ventricular dilation with mildly reduced systolic function (LVEF 45%) without evidence of fibrosis, inflammation, or infiltration.2. Mild right ventricular dilation with mildly reduced systolic function (RVEF 44%) with evidence of an aneurysmal RVOT and patch repair. 3. The main PA has evidence of valved conduit. The proximal portion is normal in size. Distally, there is a narrowing which extends into the left pulmonary artery (13x12mm) with evidence of flow acceleration. The right pulmonary artery is normal in size.4. Moderate tricuspid regurgitation. 5. There is clockwise rotation of the aortic root. 