26 year old female with VSD repair as child. TTE shows RV dysfunction. Patient is referred to exclude residual shunt. Left VentricleThe left ventricle is normal in size with low normal systolic function. The overall LV ejection fraction is 54%, the LV end diastolic volume index is 88 ml/m2 (normal range: 65+/-11), the LVEDV is 172 ml (normal range 109+/-23), the LV end systolic volume index is 40 ml/m2 (normal range 18+/-5), the LVESV is 79 ml (normal range 31+/-10), the LV mass index is 46 g/m2 (normal range 67+/-11), and the LV mass is 90 g (normal range 114+/-24). There are no regional wall motion abnormalities present. Evidence of VSD patch repair noted without evidence of residual shunting.Left AtriumThe left atrium is normal in size. No atrial septal defect is noted. Qp/Qs<1. Right VentricleThe right ventricle is upper normal in size with normal systolic function. The overall RV ejection fraction is 51%, the RV end diastolic volume index is 97 ml/m2 (normal range 69+/-14), the RVEDV is 189 ml (normal range 110+/-24), the RV end systolic volume index is 47 ml/m2 (normal range 22+/-8), and the RVESV is 92 ml (normal range 35+/-13). Right AtriumThe right atrium is mildly dilated. Aortic ValveThe aortic valve is trileaflet and opens widely. There is mild aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is no significant 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 right-sided aortic arch with evidence of an abbarent left subclavian artery which courses posterior to the esophagus. Proximal to where the left subclavian artery crosses the esophagus, there is an air-fluid level in the esophagus but no evidence of esophageal dilation. There was no evidence of tracheal compression.Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is mildly dilated (29x31mm).Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium. PericardiumThere is no obvious pericardial disease.Extracardiac FindingsSmall residual thymus tissue is 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. Normal LV size with low normal systolic function (LVEF 54%).2. Upper normal RV size with normal systolic function (RVEF 51%).3. Evidence of membranous ventricular septal repair without residual shunt.4. Mild right atrial dilation.5. No atrial septal defect. No anomalous pulmonary venous return.6. Mild dilation of the main pulmonary artery.7. There is a right-sided aortic arch with evidence of an abbarent left subclavian artery which courses posterior to the esophagus. Proximal to where the left subclavian artery crosses the esophagus, there is an air-fluid level in the esophagus but no evidence of esophageal dilation. There was no evidence of tracheal compression.