A 40 year old female with personal history of congenital cleft tricuspid valve requiring tricuspid valve repair presenting for yearly evaluation of heart function. Left VentricleThe left ventricle is moderately dilated with normal systolic function. The overall LV ejection fraction is 55%, the LV end diastolic volume index is 103 ml/m2 (normal range: 65+/-11), the LVEDV is 175 ml (normal range 109+/-23), the LV end systolic volume index is 46 ml/m2 (normal range 18+/-5), the LVESV is 78 ml (normal range 31+/-10). There are no regional wall motion abnormalities present. There is very small area of late gadolinium enhancement in the mid inferior wall of unknown significance. This was seen on previous CMR exams. This may represent a previous fibrosing, infiltrative, or inflammatory process.Left AtriumThe left atrium is normal in size (73ml).Right VentricleThe right ventricle is severely dilated with mildly decreased systolic function. The overall RV ejection fraction is 48%, the RV end diastolic volume index is 130 ml/m2 (normal range 69+/-14), the RVEDV is 221 ml (normal range 110+/-24), the RV end systolic volume index is 68 ml/m2 (normal range 22+/-8), and the RVESV is 115 ml (normal range 35+/-13). Right AtriumThe right atrium is mildly dilated (102ml). Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely, there is thickening of the leaflets and there is no significant mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThere is evidence of tricuspid valve repair with annuloplasty ring present. There is qualitatively mild-moderate tricuspid regurgitation. TR RF (from LV and RV volumes) is < 10%.AortaThere is a left sided aortic arch with a normal brachiocephalic branching pattern. The aortic root is normal in size.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 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 moderately dilated with normal systolic function, the LVEF is 55%. There are no regional wall motion abnormalities present. 2. There is small area of late gadolinium enhancement in the mid inferior wall of unknown significance. This was seen on previous CMR exams. This may represent a previous fibrosing, infiltrative, or inflammatory process.3. The right ventricle is severely dilated with mildly decreased systolic function, the RVEF is 48%. 4. Mild right atrium dilation.5. There is evidence of tricuspid valve repair with annuloplasty ring present. There is qualitatively mild-moderate tricuspid regurgitation. TR RF (from LV and RV volumes) is < 10%.When compared to the prior study, the patient's LV and RV volumes are similar, both LV and RV EF are marginally lower, side-by-side assessment of the tricuspid regurgitation is similar.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.