69 year old man with history of Marfan's syndrome, referred for cardiac MRI for interval follow up of aortic dimensions. Left VentricleThe left ventricle is moderately dilated with normal systolic function. The overall LV ejection fraction is 53%, the LV end diastolic volume index is 138 ml/m2 (normal range: 74+/-15), the LVEDV is 317 ml (normal range 142+/-34), the LV end systolic volume index is 63 ml/m2 (normal range 25+/-9), the LVESV is 146 ml (normal range 47+/-19). There are no regional wall motion abnormalities present. 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 normal systolic function. The overall RV ejection fraction is 62%, the RV end diastolic volume index is 135 ml/m2 (normal range 82+/-16), the RVEDV is 310 ml (normal range 142+/-31), the RV end systolic volume index is 52 ml/m2 (normal range 31+/-9), and the RVESV is 190 ml (normal range 54+/-17).Right AtriumThe right atrium is normal in size.Aortic ValveThe aortic valve is tri-leaflet and opens widely. There is mild-moderate aortic regurgitation. Aortic regurgitation is central due to leaflet malcoaptation. 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 ValveThe tricuspid valve opens widely. There is no significant tricuspid regurgitation.AortaThere is a left sided aortic arch with a normal brachiocephalic branching pattern. Aortic dimensions are as follows:Sinus of Valsalva: 51 x 55 x 53mmSinotubular junction: 48 x 50mmMid ascending aorta at the level of the main pulmonary artery: 49 x 47mmAscending aorta immediately proximal to the innominate artery: 44 x 44mmDescending thoracic aorta: 30 x 30mmPulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is normal in size.Venous AnatomyThe SVC and IVC 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 moderately dilated with normal systolic function. The overall LV ejection fraction is 53%.2. The right ventricle is mildly dilated with normal systolic function. The overall RV ejection fraction is 62%.3. Severe aortic root dilation (dimensions described above), increased since last cardiac MRI in 2012. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.