A 26 year old male with Ebstein's anomaly and suspected interatrial shunt by a recent echocardiography. Referred to cardiac MRI for further evaluation. Left VentricleThe left ventricle is normal in size with normal systolic function. The overall LV ejection fraction is 60%, the LV end diastolic volume index is 55 ml/m2 (normal range: 74+/-15), the LVEDV is 94 ml (normal range 142+/-34), the LV end systolic volume index is 22 ml/m2 (normal range 25+/-9), the LVESV is 38 ml (normal range 47+/-19), the LV mass index is 33 g/m2 (normal range 85+/-15), and the LV mass is 57 g (normal range 164+/-36). There is flattening of the interventricular septum in diastole. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.Right VentricleThe non-atrialized portion of the right ventricle is mildly dilated with normal systolic function. The overall RV ejection fraction is 50%, the RV end diastolic volume index is 123 ml/m2 (normal range 82+/-16), the RVEDV is 212 ml (normal range 142+/-31), the RV end systolic volume index is 62 ml/m2 (normal range 31+/-9), and the RVESV is 106 ml (normal range 54+/-17).AtriumsThe left atrium is normal in size (36ml).The right atrium is severely dilated (201ml), when the atrialized portion of the RV is included as RA volume.No atrial septal defect was seen. No obvious right to left or left to right shunt is seen on first pass contrast imaging, and Qp/Qs is within normal limits.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 no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is severe tricuspid regurgitation. The septal leaflet is apically displaced with the coaptation point occurring at the mid-RV level.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 are normal in size and drain normally into the right atrium.PericardiumThere is a trace pericardial effusion.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. The left ventricle is normal in size with normal systolic function, the LVEF is 60%. There is flattening of the interventricular septum in diastole. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process.2. The non-atrialized portion of the right ventricle is mildly dilated with normal systolic function, the RVEF is 50%. 3. The right atrium is severely dilated (201ml), when the atrialized portion of the RV is included as RA volume.4. No atrial septal defect or anomalous pulmonary venous drainage is noted.5. The tricuspid valve is consistent with Ebstein's anomaly and has severe regurgitation.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.