72 year old man with history of recent CABG and surgical MAZE procedure with recurrent atrial fibrillation, now referred for pre-ablation cardiac MRI. Left VentricleThe left ventricle is mildly dilated with mildly reduced systolic function. The overall LV ejection fraction is 49%, the LV end diastolic volume index is 105 ml/m2 (normal range: 74+/-15), the LVEDV is 218 ml (normal range 142+/-34), the LV end systolic volume index is 53 ml/m2 (normal range 25+/-9), the LVESV is 110 ml (normal range 47+/-19), the LV mass index is 62 g/m2 (normal range 85+/-15), and the LV mass is 128 g (normal range 164+/-36). There are no regional wall motion abnormalities present. There is a small area of late gadolinium enhancement in the mid inferolateral wall which is subendocardial and which is likely the focus of previous myocardial infarction or less likely an underlying fibrosing, infiltrative, or inflammatory process.Left AtriumThe left atrium is mildly dilated with a maximal LA volume of 117mL. The interatrial septum is thickened. There is no evidence of left atrial appendage thrombus.Right VentricleThe right ventricle is mildly dilated with mildly reduced systolic function. The overall RV ejection fraction is 47%, the RV end diastolic volume index is 120 ml/m2 (normal range 82+/-16), the RVEDV is 249 ml (normal range 142+/-31), the RV end systolic volume index is 63 ml/m2 (normal range 31+/-9), and the RVESV is 131 ml (normal range 54+/-17).Right AtriumThe right atrium is mildly dilated. The maximal RA volume is 139mL.Aortic ValveThe aortic valve opens widely and there is trivial aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is at least mild mitral regurgitation which is eccentrically directed.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is at least mild tricuspid regurgitation.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.The dimensions are as follows:RUPV: 24 x 18mmRLPV: 22 x 20mmLUPV: 21 x 15mmLLPV: 14 x 15 mmPulmonary ArteryThe main pulmonary artery is upper normal in size.Venous AnatomyThe SVC and IVC drain normally into the right atrium.PericardiumThere is no obvious pericardial disease.Extracardiac FindingsSmall left pleural effusion with layering in the upper oblique fissure. Sternotomy wires are present. 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 mildly dilated with mildly reduced systolic function. The overall LV ejection fraction is 49%2. There is a small area of late gadolinium enhancement in the mid inferolateral wall which is subendocardial and given the patient's history of previous CABG is likely the focus of a previous myocardial infarction3. The right ventricle is mildly dilated with mildly reduced systolic function. The overall RV ejection fraction is 47%4. There is mild biatrial enlargement.5. Pulmonary vein measurements are as given above6. See extra-cardiac findings. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.