32 year old woman with coarctation of the aorta s/p bypass graft referred for repeat cardiac MRI for evaluation of her aorta. Left VentricleThe left ventricle is normal in size and systolic function. The overall LV ejection fraction is 69%, the LV end diastolic volume index is 75 ml/m2 (normal range: 65+/-11), the LVEDV is 154 ml (normal range 109+/-23), the LV end systolic volume index is 23 ml/m2 (normal range 18+/-5), the LVESV is 48 ml (normal range 31+/-10), the LV mass index is 52 g/m2 (normal range 67+/-11), and the LV mass is 106 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. No intracardiac thrombus.Left AtriumThe left atrium is normal in size.Right VentricleThe right ventricle is normal in size and systolic function. The overall RV ejection fraction is 57%, the RV end diastolic volume index is 76 ml/m2 (normal range 69+/-14), the RVEDV is 157 ml (normal range 110+/-24), the RV end systolic volume index is 33 ml/m2 (normal range 22+/-8), and the RVESV is 89 ml (normal range 35+/-13). Right AtriumThe right atrium is mildly dilated. Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation. Aortic valve is trileaflet.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 no thoracic aortic aneurysm or thoracic aortic dissection. There is evidence of a severe aortic coarctation with nearly complete occlusion of the descending aorta just distal to the left subclavian artery. The coarctation is bypassed by a graft originating at the level immediately distal to the left subclavian artery origin. The graft is widely patent. The mean gradient across the bypass graft is negligible (1.4mmHg).Sinus of Valsalva: 29 x 30mmSinotubular Junction: 27mmAscending Aorta: 28 x 26mmDescending Aorta: 18 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 normal in size and drain normally into the right atrium. PericardiumThere is no pericardial effusion.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. There is evidence of a severe aortic coarctation with nearly complete occlusion of the descending aorta just distal to the left subclavian artery. The coarctation is bypassed by a graft originating at the level immediately distal to the left subclavian artery origin. The graft is widely patent.2. Normal LV size and systolic function (LVEF 69%) without evidence of underlying myocardial fibrosis, inflammation, or infiltration.3. Normal RV size and systolic function (RVEF 57%).I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.