63 year old male with ischemic cardiomyopathy presenting for evaluation of viability and left ventricular systolic function. Left VentricleThe left ventricle is severely dilated with severely reduced systolic function. The overall LV ejection fraction is 27%, the LV end diastolic volume index is 156 ml/m2 (normal range: 74+/-15), the LVEDV is 340 ml (normal range 142+/-34), the LV end systolic volume index is 114 ml/m2 (normal range 25+/-9), the LVESV is 249 ml (normal range 47+/-19), the LV mass index is 64 g/m2 (normal range 85+/-15), and the LV mass is 139 g (normal range 164+/-36). There is significant transmural late gadolinium enhancement in a pattern consistent with myocardial infarction involving the left anterior descending and right coronary artery. These areas are not likely to be viable. The basal and mid lateral wall and part of the basal anterior, anterolateral walls are viable.No intracardiac thrombus.Left AtriumThe left atrium is severely dilated. 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 97 ml/m2 (normal range 82+/-16), the RVEDV is 212 ml (normal range 142+/-31), the RV end systolic volume index is 48 ml/m2 (normal range 31+/-9), and the RVESV is 104 ml (normal range 54+/-17).Right AtriumThe right atrium is normal in size.Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve has bileaflet tethering, opens widely and there is at least mild mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is at least trivial 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. The aortic root is normal in size.Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is dilated (31mm).Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium.PericardiumThere is no pericardial effusion.
1. The left ventricle is severely dilated with severely reduced systolic function. The overall LV ejection fraction is 27%2. There is extensive LGE consistent with previous infarct as described above. 3. The right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 51%.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.