15 year old female with a history of repaired Tetralogy of Fallot and a history of pulmonic regurgitation and mild pulmonic stenosis by echocardiography referred from cardiac MRI. Left VentricleThe left ventricle is normal in size and systolic function. The overall LV ejection fraction is 66%, the LV end diastolic volume index is 76 ml/m2 (normal range: 65+/-11), the LVEDV is 122 ml (normal range 109+/-23), the LV end systolic volume index is 26 ml/m2 (normal range 18+/-5), the LVESV is 42 ml (normal range 31+/-10), the LV mass index is 37 g/m2 (normal range 67+/-11), and the LV mass is 60 g (normal range 114+/-24). There is evidence of a small ventricular septal defect adjacent to the VSD patch site. There are no regional wall motion abnormalities present. There is no left ventricular 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 55%, the RV end diastolic volume index is 103 ml/m2 (normal range 69+/-14), the RVEDV is 166 ml (normal range 110+/-24), the RV end systolic volume index is 46 ml/m2 (normal range 22+/-8), and the RVESV is 74 ml (normal range 35+/-13). There is late gadolinium enhancement of the RVOT outflow patch repair. Right AtriumThe right atrium is mildly dilated. Aortic ValveThe aortic valve is trileaflet, opens widely and there is no significant aortic regurgitation. Mitral ValveThe mitral valve opens widely and there is no significant mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is at least moderate pulmonic regurgitation (regurgitant volume 26ml, regurgitant fraction 33%). Tricuspid ValveThe tricuspid valve opens widely. There is at least moderate tricuspid regurgitation.AortaThe aortic root mildly over-rides the interventricular septum. There is a right-sided aortic arch with a mirror image brachiocephalic branching pattern. The aortic root is normal in size (sinus of Valsalva 31x31x33mm). There is normal origin of the coronary arteries. Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is normal in size. The LPA takes a sharp angle at its take off and is mildly stenosed. The measurements are:MPA= 19x20mmRPA= 15x16mmLPA= 11x12mmVenous AnatomyThe SVC and IVC are normal in size and 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. Tetralogy of Fallot morphology s/p repair2. Normal left ventricular size and systolic function (LVEF 66%).3. Mild right ventricular dilation with normal systolic function (RVEF 55%) with evidence of RVOT patch repair.4. Small, residual, membranous ventricular septal defect.5. Mild right atrial dilation.6. At least moderate tricuspid valve regurgitation. 7. At least moderate pulmonic valve regurgitation.8. Mild stenosis of ostial left pulmonary artery. 9. Right-sided aortic arch with mirror image brachiocephalic branching. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.