48 year old female with a history of congenital pulmonary stenosis s/p PVR with pulmonic insufficiency and known pulmonary artery aneurysm. She is now referred for cardiac assessment and follow-up of pulmonary artery dimensions. Height: 170cmWt 113kgLeft VentricleThe left ventricle is normal in size and systolic function. The overall LV ejection fraction is 63%, the LV end diastolic volume index is 81 ml/m2 (normal range: 65+/-11), the LVEDV is 188 ml (normal range 109+/-23), the LV end systolic volume index is 30 ml/m2 (normal range 18+/-5), the LVESV is 70 ml (normal range 31+/-10), the LV mass index is 59 g/m2 (normal range 67+/-11), and the LV mass is 137g (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.Left AtriumThe left atrium is moderately dilated. Right VentricleThe right ventricle is mildly dilated with normal systolic function. The overall RV ejection fraction is 44%, the RV end diastolic volume index is 106 ml/m2 (normal range 69+/-14), the RVEDV is 245 ml (normal range 110+/-24), the RV end systolic volume index is 60 ml/m2 (normal range 22+/-8), and the RVESV is 138 ml (normal range 35+/-13). Right AtriumThe right atrium is again dilated. Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and visually there is trace mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is moderate pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. Visually there is trace tricuspid regurgitation.AortaThe aortic root is normal in size. There is a left sided aortic arch with a normal brachiocephalic branching pattern. There is no thoracic aortic aneurysm. Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is severely dilated. Measurements using 3D volumetric data demonstrate the following:Proximal main PA: 32mm x 34mmDistal main PA: 49 x 51 mmLeft PA (proximal): 47 x 38 mmLeft PA (distal): 30 x 31 mmRight PA: 36 x 35 mmThese values are stable when compared to previously obtained measurements. Proximal main PA: 33x33mm Distal main PA: 45mmx43mm (remeasured using the same technique as above as 55 x 49 mm)Left PA (proximal): 35x44mm (remeasured using the same technique as above as 47 x 38 mm)Left PA (distal): 36x36mm (remeasured using the same technique as above as 31 x 30 mm).Right PA: 34x33mm (remeasured using the same technique as above as 34 x 37 mm).Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium. PericardiumThere is no obvious pericardial disease.Extracardiac Findings 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 left ventricular size and systolic function (LVEF 63%).2. Moderately dilated right ventricular size and low normal systolic function (RVEF 44%), slightly worse compared to last study.3. Moderate pulmonary valve regurgitation (visual estimate).4. Dilated right atrium, as before.5. Severe pulmonary arterial dilation, not substantially different compared to previous study. Quantitative differences in measurement are likely related to differences in technique.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.