26 year old man with history of D-TGA, s/p corrective arterial switch surgery, referred for evaluation of anatomy and fibrosis. Situs /positionCardiac situs is normal as is abdominal organ position. L and R ventricles are normally positioned, as are the RA and LA. The IVC and SVC are normally positioned. The PA is anterior to the aorta c/w D-TGA arterial switch surgical correction.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 94 ml/m2 (normal range: 74+/-15), the LVEDV is 181 ml (normal range 142+/-34), the LV end systolic volume index is 42 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. No shunts are noted.Left AtriumThe left atrium is normal in size. The interatrial septum is thickened ? surgical repair.Right VentricleThe right ventricle is normal in size with lower normal systolic function. The overall RV ejection fraction is 52%, the RV end diastolic volume index is 100 ml/m2 (normal range 82+/-16), the RVEDV is 193 ml (normal range 142+/-31), the RV end systolic volume index is 48 ml/m2 (normal range 31+/-9), and the RVESV is 92 ml (normal range 54+/-17).Right AtriumThe right atrium is normal in size.Aortic ValveThe aortic valve is tri-leaflet and opens widely. 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 trace pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is no significant tricuspid regurgitation.AortaThere is a left sided aortic arch that arises from the morphologic left ventricle. There is a normal brachiocephalic branching pattern. The left coronary artery originates from the usual location on the left coronary cusp. The right coronary artery origin is not well seen. There is no aortic coarctation. The aortic root dimensions are as follows:Sinus of Valsalva: 38mm x 39mm x 38mmSinotubular Junction: 28mm x 26mmAscending Aorta: 30mm x 30mmPulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe pulmonary artery arises form the morphologic right ventricle and is anterior to the ascending aorta. The R PA appears normal, there is narrowing in the proximal L PA (12-14 mm) as it courses next to the aorta, then enlarges to a more normal diameter.Venous AnatomyThe SVC and IVC 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. The left ventricle is normal in size with low normal systolic function. The overall LV ejection fraction is 55%. There is no late gadolinium enhancement to suggest the presence of an underlying fibrosing, infiltrative, or inflammatory process. 2. The right ventricle is normal in size with low normal systolic function. The overall RV ejection fraction is 52%.3. D-TGA s/p corrective arterial switch surgery with aorta arising from morphologic LV and PA arising anterior to the Ao from morphologic RV. 4. No significant shunts or congenital structural abnormalities noted.5. There is narrowing in the proximal L PA. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.