22 year old man with bicuspid aortic valve, referred for further evaluation of aortic regurgitation and aortic root size. Left VentricleThe left ventricle is moderately dilated with low normal systolic function. The overall LV ejection fraction is 53%, the LV end diastolic volume index is 129 ml/m2 (normal range: 74+/-15), the LVEDV is 247 ml (normal range 142+/-34), the LV end systolic volume index is 61 ml/m2 (normal range 25+/-9), the LVESV is 116 ml (normal range 47+/-19), the LV mass index is 62 g/m2 (normal range 85+/-15), and the LV mass is 118 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.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 51%, the RV end diastolic volume index is 109 ml/m2 (normal range 82+/-16), the RVEDV is 208 ml (normal range 142+/-31), the RV end systolic volume index is 53 ml/m2 (normal range 31+/-9), and the RVESV is 102 ml (normal range 54+/-17).Right AtriumThe right atrium is normal in size.Aortic ValveThe aortic valve opens widely and is bicuspid with fusion of the right and left aortic leaflets. There is moderate aortic regurgitation (regurgitant fraction 25%) eccentrically directed towards the anterior mitral valve leaflet. Mitral ValveThe mitral valve opens widely and there is trace mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is mild tricuspid regurgitation.AortaThere is a left sided aortic arch with a normal brachiocephalic branching pattern. No aortic coarctation noted. Aorta dimensions as below:SOV: 32mm x 35mm x 33mmSTJ: 32mm x 32mmAscending Aorta: 34mm x 33mmAortic Arch: 22mm x 21mmDescending Thoracic Aorta: 18mm x 18mmPulmonary 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 drain normally into the right atrium.PericardiumThere is no obvious pericardial disease.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 moderately dilated with low normal systolic function. The overall LV ejection fraction is 53%. No underlying myocardial fibrosis, inflammation, or infiltration. 2. The right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 51%.3. The aortic valve is bicuspid. There is moderate aortic regurgitation without aortic valve stenosis.4. Normal thoracic aorta size without evidence of coarctation, aneurysm, or dissection.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.