25 year old man with history of Tetrology of Fallot, s/p repair and bioprosthetic pulmonic valve placement, referred for CMR for follow up. General Anatomy: Tetrology of Fallot s/p complete repair (with VSD closure and transannular RVOT patch).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 74 ml/m2 (normal range: 74+/-15), the LVEDV is 152 ml (normal range 142+/-34), the LV end systolic volume index is 39 ml/m2 (normal range 25+/-9), the LVESV is 81 ml (normal range 47+/-19). 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 mildly dilated with severely reduced systolic function. The overall RV ejection fraction is 25%, the RV end diastolic volume index is 116 ml/m2 (normal range 82+/-16), the RVEDV is 239 ml (normal range 142+/-31), the RV end systolic volume index is 86 ml/m2 (normal range 31+/-9), and the RVESV is 178 ml (normal range 54+/-17). There is hypokinesis proximal to the RVOT. No shunts are noted visually or on first pass contrast. Qp/Qs is not abnormal.Right AtriumThe right atrium is moderately dilated.Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is no significant mitral regurgitation.Pulmonic ValveA bioprosthetic pulmonic valve is present. There is mild pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is mild tricuspid regurgitation.AortaThere is a right sided aortic arch with a mirror image 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 (27mm). There are no significant stenoses of the main or first order branch of the pulmonary arteries.Venous AnatomyThe SVC and IVC drain normally into the right atrium.PericardiumThere is no obvious pericardial disease.Extracardiac FindingsSternal 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. Post Tetrology of Fallot repair with no significant shunts2. The right ventricle is mildly dilated with severely reduced systolic function. The overall RV ejection fraction is 25%. The RV end diastolic volume index is 116 ml/m2 and the RVEDV is 239 ml.3. A bioprosthetic pulmonic valve is present with mild pulmonic regurgitation.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.