58 year old man with history of HTN, AF, referred for cardiac MRI prior to planned AF ablation. Left VentricleThe left ventricle is normal in size with normal systolic function. The overall LV ejection fraction is 51%, the LV end diastolic volume index is 62 ml/m2 (normal range: 74+/-15), the LVEDV is 142 ml (normal range 142+/-34), the LV end systolic volume index is 30 ml/m2 (normal range 25+/-9), the LVESV is 70 ml (normal range 47+/-19), the LV mass index is 44 g/m2 (normal range 85+/-15), and the LV mass is 103 g (normal range 164+/-36). 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.No intracardiac thrombus.Left AtriumThe left atrial volume is 190.7ml. The left atrial volume index is 82.5ml/m2, which is severely increased. There is artifact on the dedicated 3-dimensional delayed viability sequences. No reliable evidence of left atrial enhancement.Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 51%, the RV end diastolic volume index is 65 ml/m2 (normal range 82+/-16), the RVEDV is 151 ml (normal range 142+/-31), the RV end systolic volume index is 32 ml/m2 (normal range 31+/-9), and the RVESV is 75 ml (normal range 54+/-17).Right AtriumThe right atrium is severely dilated.Aortic ValveThe aortic valve is tri-leaflet and opens widely. There is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is no significant mitral regurgitation. The mitral valve leaflets appear thickened.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is trace tricuspid regurgitation.AortaThere is a left sided aortic arch with a common origin of the innominate and left common carotid arteries (normal variant). The aortic root is normal in size.Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium. Individual dimensions are:RUPV:16x17mm. There is either early branching or common origin of right middle lobe branches.RLPV: 21X26mm. There is early branching.LUPV: 14x16mmLLPV: 16x8mmPulmonary 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 pericardial effusion effusion.
1. The left ventricle is normal in size with normal systolic function. The overall LV ejection fraction is 51%. There is no late gadolinium enhancement in the left ventricle to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.2. The right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 51%.3. The left atrial volume index is 82.5ml/m2, which is severely increased. 4. Early branching of the right superior and inferior pulmonary veins. Two left pulmonary veins drain normally into the left atrium, dimensions as above. 5. Severe bi-atrial enlargement. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.