A 41 year old female with history of idiopathic aortitis, status post ascending aortic aneurysm repair and mechanical aortic valve placement in August 2010. The patient is asymptomatic and was referred to cardiac MRI to evaluate the stability of aneurysm and valve repair. Left VentricleThe left ventricle is normal in size with normal systolic function. The overall LV ejection fraction is 59%, the LV end diastolic volume index is 87 ml/m2 (normal range: 65+/-11), the LVEDV is 131 ml (normal range 109+/-23), the LV end systolic volume index is 36 ml/m2 (normal range 18+/-5), the LVESV is 53 ml (normal range 31+/-10), the LV mass index is 36 g/m2 (normal range 67+/-11), and the LV mass is 56 g (normal range 114+/-24). 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. Septal bounce was noted.Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 57%, the RV end diastolic volume index is 78 ml/m2 (normal range 69+/-14), the RVEDV is 116 ml (normal range 110+/-24), the RV end systolic volume index is 33 ml/m2 (normal range 22+/-8), and the RVESV is 50 ml (normal range 35+/-13). Right AtriumThe right atrium is normal in size. Aortic ValveArtefacts were noted due to the mechanical aortic valve replacement, there is mild regurgitation (regurgitation fraction 14% by Q-flow analysis).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 left sided aortic arch with a normal brachiocephalic branching pattern. There is an ascending aortic graft with no aneurysm formation noted; however, there is mild dilation of the ascending aorta just distal to the anastomosis site of the graft. This finding was noted in the 2 previous MRI's (2012, 2013).Aortic diameters: Ascending aortic graft maximum diameter: 31mm (31 mm in 2013, 30 mm in 2012).Distal anastomosis: 22mm (23mm in 2013, 23mm in 2012).There is an area of mild dilatation just distal to the anastomosis site that measures 32 x 36mm - this has not changed when compared to the 2013 or 2012 CMR.Ascending aorta just proximal to brachiocephalic vessels: 31mm (30mm in 2013 and 2012).Distal arch: 23mm (23mm in 2013 and 2012).Descending aorta at the level of the main PA: 17mm (17mm in 2013 and 2012).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 no obvious pericardial disease.Extracardiac FindingsSternal wires. 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 normal in size with normal systolic function, the LVEF is 59%, no evidence of an underlying fibrosing, infiltrative, or inflammatory process. Septal bounce was noted.2. The right ventricle is normal in size with normal systolic function, the RVEF is 57%.3. Mechanical aortic valve, there is mild regurgitation (regurgitation fraction 14% by Q-flow analysis).4. Ascending aortic graft, no aneurysm noted; however, there is mild dilation of the ascending aorta just distal to the anastomosis site of the graft.5. When compared to the prior study, no significant change is noted.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.