27 year old female with AV canal defect s/p repair presenting for cardiac evaluation Left VentricleThe left ventricle is normal in size with mildly reduced systolic function. The overall LV ejection fraction is 47%, the LV end diastolic volume index is 95 ml/m2 (normal range: 65+/-11), the LVEDV is 165 ml (normal range 109+/-23), the LV end systolic volume index is 50 ml/m2 (normal range 18+/-5), the LVESV is 87 ml (normal range 31+/-10), the LV mass index is 50 g/m2 (normal range 67+/-11), and the LV mass is 87 g (normal range 114+/-24). There is evidence of a patch repair of the membranous ventricular septum without visible shunt. There is a prominent diverticulum in the basal inferior wall. 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.Right VentricleThe right ventricle is moderately enlarged with mildly reduced systolic function. The overall RV ejection fraction is 47%, the RV end diastolic volume index is 113 ml/m2 (normal range 69+/-14), the RVEDV is 197 ml (normal range 110+/-24), the RV end systolic volume index is 60 ml/m2 (normal range 22+/-8), and the RVESV is 104 ml (normal range 35+/-13). AtriaThe left atrium is normal in size. The right atrium is moderately enlarged. There is evidence of a patch repair of the interatrial septum. Qp/Qs is approximately 1. Aortic ValveThe aortic valve is trileaflet opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is mild mitral regurgitation. Notable abnormal morphology of the mitral valve consistent with history of AV canal defect and surgical repair. Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is no significant tricuspid regurgitation. Notably the level of the tricuspid and mitral valves is the same, consistent with history of AV canal defect. 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 AnatomyThere is a left sided SVC draining directly into the coronary sinus. Notably no right sided SVC was seen. The IVC is normal in size and drain normally into the right atrium. PericardiumThere is no obvious pericardial disease.Extracardiac FindingsThere are Harrington rods within the cervical spine creating extensive artifact. Sternal 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 normal in size with mildly reduced systolic function. The overall LV ejection fraction is 47%. There is a prominent LV diverticulum in the basal inferior wall which may be related to previous surgery. There are no regional wall motion abnormalities present and no LGE. 2. The right ventricle is moderately enlarged with mildly reduced systolic function. The overall RV ejection fraction is 47%3. Evidence of patch repair of ASD and VSD with abnormal morphology of AV valves consistent with known congenital defect with surgical repair. 4. No evidence of clinically significant intracardiac shunt (Qp/Qs is 1). 5. Mild mitral regurgitation. 6. Persistent left-sided SVC draining into coronary sinus. No right-sided SVC noted. 