A 19 year old female with an atrial septal defect which was percutaneously closed on 2009 who was referred to cardiac MRI for evaluation of a residual defect after symptoms of shortness of breath and chest pain. Left VentricleThe left ventricle is normal in size with normal systolic function. The overall LV ejection fraction is 55%, the LV end diastolic volume index is 71 ml/m2 (normal range: 65+/-11), the LVEDV is 119 ml (normal range 109+/-23), the LV end systolic volume index is 32 ml/m2 (normal range 18+/-5), the LVESV is 54 ml (normal range 31+/-10), the LV mass index is 25 g/m2 (normal range 67+/-11), and the LV mass is 43 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.Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 53%, the RV end diastolic volume index is 70 ml/m2 (normal range 69+/-14), the RVEDV is 117 ml (normal range 110+/-24), the RV end systolic volume index is 33 ml/m2 (normal range 22+/-8), and the RVESV is 55 ml (normal range 35+/-13). AtriumsThe left atrium is normal in size. The LA volume is 51 ml.The right atrium is normal in size. The Qp:Qs ratio is normal (0.93). By recent transthoracic echocardiogram (TTE) with agitated saline, bubbles were noted to cross the interatrial septum, left to right. There is minimal high signal on both sides of the interatrial septum, close to the metallic closure device, upon dedicated first pass imaging with saturation. While this may be artifactual, in the presence of previous documented bubbles crossing the septum on TTE, trace flow around or adjacent to the device may be considered. Identification of such small potential flow may be limited by spacial resolution of MRI. Of note, no moderate or large partial anomalous right superior pulmonary vein was identified ( which can be present in the setting of superior sinus venosus atrial septal defect).Aortic ValveThe aortic valve is trileaflet, opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is no significant mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is pulmonic regurgitation, estimated to be trace. 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 normal in size. 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 normal in size with normal systolic function, the LVEF is 55%. There are no regional wall motion abnormalities present. 2. The right ventricle is normal in size with normal systolic function, the RVEF is 53%. 3. The left atrium is normal in size (LA volume is 51 ml). An ASD closure device (Helix device) occupies the inter-atrial septum at expected location for valve of fossa ovalis. The Qp:Qs ratio is 0.93; no significant shunt is present. Further details are reviewed, above.4. The right atrium is normal in size.  I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.