30 year old with Marfan's syndrome with history of ASD repair and known dilated aorta presenting for evaluation of aorta and left ventricular function. Left VentricleThe left ventricle is severely dilated with low normal systolic function. The overall LV ejection fraction is 53%, the LV end diastolic volume index is 128 ml/m2 (normal range: 65+/-11), the LVEDV is 241 ml (normal range 109+/-23), the LV end systolic volume index is 61 ml/m2 (normal range 18+/-5), the LVESV is 114 ml (normal range 31+/-10), the LV mass index is 43 g/m2 (normal range 67+/-11), and the LV mass is 80 g (normal range 114+/-24). 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 sizeRight VentricleThe right ventricle is mild to moderately dilated with normal systolic function. The overall RV ejection fraction is 50%, the RV end diastolic volume index is 111 ml/m2 (normal range 69+/-14), the RVEDV is 210 ml (normal range 110+/-24), the RV end systolic volume index is 55 ml/m2 (normal range 22+/-8), and the RVESV is 105 ml (normal range 35+/-13). Right AtriumThe right atrium is normal in size. Aortic ValveThe aortic valve opens widely and there is mild aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is trace 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. The aortic root is dilated with effacement of the sinotubular junction and dilated sinus of Valsalva. The most dilated portion of the aortic root is 50 mm x 43 mm approximately 2 cm above the aortic valve plane. Annulus measures approximately 3.1 x 2.1 cm.Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is normal in size. Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium. PericardiumThere is no obvious pericardial disease.Extracardiac FindingsSternotomy wires present. 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. The aortic root is dilated with effacement of the sinotubular junction and dilated sinus of Valsalva. The most dilated portion of the aortic root is 50 mm x 43 mm approximately 2 cm above the aortic valve plane. There is mild aortic regurgitation. 2. The left ventricle is severely dilated with low normal systolic function. The overall LV ejection fraction is 53%. 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.3. The right ventricle is mild to moderately dilated with normal systolic function. The overall RV ejection fraction is 50%.