A 20 year old male with tetrallogy of Fallot, repair in infancy. On 10/2014 hospitalization due to pleuritis, likely viral. Echocardiography (12/23/2014) showed mildly reduced LVEF, mild-moderate RV systolic dysfunction, mild PS, mild-mod PR, mild TR, dilated aortic root. Referred to cardiac MRI for assessment Left VentricleThe left ventricle is mildly dilated with mildly reduced systolic function. The overall LV ejection fraction is 48%, the LV end diastolic volume index is 110 ml/m2 (normal range: 74+/-15), the LVEDV is 188 ml (normal range 142+/-34), the LV end systolic volume index is 57 ml/m2 (normal range 25+/-9), the LVESV is 98 ml (normal range 47+/-19), the LV mass index is 50 g/m2 (normal range 85+/-15), and the LV mass is 86 g (normal range 164+/-36). There is septal hypokinesis and dyssynergy. 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 moderately dilated with moderately reduced systolic function. The overall RV ejection fraction is 35%, the RV end diastolic volume index is 139 ml/m2 (normal range 82+/-16), the RVEDV is 239 ml (normal range 142+/-31), the RV end systolic volume index is 90 ml/m2 (normal range 31+/-9), and the RVESV is 154 ml (normal range 54+/-17).Right AtriumThe right atrium is mildly dilated.ShuntNo interatrial or interventricular shunt was noted.Aortic ValveThe aortic valve is trileaflet, opens widely and there is trace aortic regurgitation (regurgitant fraction 3%).Mitral ValveThe mitral valve opens widely and there is no significant mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is mild-moderate pulmonic regurgitation (regurgitant fraction 5%). No significant stenosis was noted.Tricuspid ValveThe tricuspid valve opens widely. There is mild tricuspid regurgitation.AortaThere is a left sided aortic arch with a normal brachiocephalic branching pattern. The aortic root is mildly dilated. Contrast 3D whole heart used for measurements.Sinus of Valsalva: Width: 45mm x 46mm x 43mmSinotubular Junction: 43 mm x 44 mmAscending Aorta (5cm from annulus): 40 mm x 40 mmMid Aortic Arch: 33 mm x 30 mmDescending Aorta: 20mm x 21 mmPulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is normal in size (30 x 26mm). LPA measures 26 x 21 mm. RPA measures 15 x 17 mm.Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium.PericardiumThere is no pericardial effusion.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 mildly dilated with mildly reduced systolic function, the LVEF is 48%. There is septal hypokinesis with septal bounce. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.3. The right ventricle is moderately dilated with moderately reduced systolic function, the RVEF is 35%. 4. The right atrium is mildly dilated. 5. No interatrial or interventricular shunt was noted.7. There is mild-moderate pulmonic regurgitation (regurgitant fraction 5%). No significant stenosis was noted.9. The aortic root is mildly dilated (see measurements above). See also main PA and branch PA measurements above.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.