A 38 year old male with bicuspid aortic valve referred to cardiac MRI for further evaluation. Left VentricleThe left ventricle is in the upper limit of normal size with normal systolic function. The overall LV ejection fraction is 61%, the LV end diastolic volume index is 104 ml/m2 (normal range: 74+/-15), the LVEDV is 231 ml (normal range 142+/-34), the LV end systolic volume index is 52 ml/m2 (normal range 25+/-9), the LVESV is 116 ml (normal range 47+/-19), the LV mass index is 41 g/m2 (normal range 85+/-15), and the LV mass is 90 g (normal range 164+/-36). There are no regional wall motion abnormalities present. No evidence of myocardial late gadolinium enhancement to suggest underlying myocardial fibrosis, inflammation, or infiltration. 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 118 ml/m2 (normal range 82+/-16), the RVEDV is 248 ml (normal range 142+/-31), the RV end systolic volume index is 42 ml/m2 (normal range 31+/-9), and the RVESV is 93 ml (normal range 54+/-17).Right AtriumThe right atrium is normal in size.Aortic ValvePatient is s/p aortic valve and aortic replacement. There is normal leaflet excursion. There is moderate aortic regurgitation. The regurgitant volume is 32ml and the regurgitant fraction is 28%.Mitral ValveThe mitral valve opens widely and there is no significant mitral regurgitation.Pulmonic ValveThe pulmonic valve leaflets are thickened but open widely. There is moderate pulmonic regurgitation. His regurgitant volume is 41ml and his regurgitant fraction is 34%.Tricuspid ValveThe tricuspid valve opens widely. There is trace tricuspid regurgitation.AortaThere is a left sided aortic arch with a pseudo-bovine brachiocephalic branching pattern. An aortic root replacement is noted. There is no residual thoracic aortic aneurysm, dissection, or coarctation noted. The aortic measurements are as below:Sinus of Valsalva: 38x41mmSinotubular Junction: 31x33mmAscending Aorta: 32x33mmAortic Arch: 26x27mmDescending Aorta: 26x27mmPulmonary 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 FindingsSternal wires are 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. The left ventricle is in the upper limit of normal size with normal systolic function, the LVEF is 61%. 2. The right ventricle is mildly dilated with normal systolic function, the RVEF is 62%. 3. An aortic valve and aortic root replacement are noted. There is mild thickening of the aortic valve with evidence of moderate aortic regurgitation.4. The pulmonic valve leaflets are thickened with moderate pulmonic valve regurgitation. 5. No evidence of thoracic aortic aneurysm, dissection, or coarctation. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.