39 year old male with a history of congenital VSD s/p repair in childhood, repaired residual LV to RA shunt, s/p TV repair in 2014, and SVT/atrial flutter ablation. Left VentricleThe left ventricle is mildly dilated with mildly reduced systolic function. The overall LV ejection fraction is 46%, the LV end diastolic volume index is 114 ml/m2 (normal range: 74+/-15), the LVEDV is 222 ml (normal range 142+/-34), the LV end systolic volume index is 62 ml/m2 (normal range 25+/-9), the LVESV is 121 ml (normal range 47+/-19), the LV mass index is 29 g/m2 (normal range 85+/-15), and the LV mass is 57 g (normal range 164+/-36). There are no regional wall motion abnormalities present. There is thinning with very small area of transmural LGE in the apical antero-lateral wall. This was seen on the last two MRIs (2011 and 2014) and is of unclear significance. It may represent presence of an underlying fibrosing, infiltrative, or inflammatory process. No evidence of VSD. Site of VSD repair seen. Native T1 myocardial time = 1050 ms.Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is moderately dilated and moderately reduced systolic function. The overall RV ejection fraction is 40%, the RV end diastolic volume index is 139 ml/m2 (normal range 82+/-16), the RVEDV is 222 ml (normal range 142+/-31), the RV end systolic volume index is 62 ml/m2 (normal range 31+/-9), and the RVESV is 121 ml (normal range 54+/-17). Some turbulence noted at the infundibulum on cine images of the RVOT. When compared with previous MRI (2014) the turbulence dose not appear as significant. MRA with main PA measurements not performed on this study. Right AtriumThe right atrium is mildly 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 ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve is consistent with repair. There is an annuloplasty ring present. There is at least mild-moderate tricuspid regurgitation.AortaThere is a left sided aortic arch with a normal brachiocephalic branching pattern. The aortic root is normal in size (35.7 mm).Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is normal in size (25.6 mm).Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium.PericardiumThere is no obvious pericardial disease.Extracardiac FindingsSternal wires noted. 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. The left ventricle is mildly dilated with mildly reduced systolic function. (LVEF 46%).2. The right ventricle is moderately dilated with moderately reduced systolic function (RVEF 40%). The RV volume is smaller on this study when compared with the study performed in 2014.3. The tricuspid valve is consistent with repair. There is an annuloplasty ring present. There is at least mild-moderate tricuspid regurgitation. Suggest correlation with echocardiogram.4. There is a small area of transmural late gadolinium enhancement in the apical segment of unclear significance but may represent presence of an underlying fibrosing, infiltrative, or inflammatory process.5. No residual VSD. 6. Mildly dilated RA. This is a significant improvement from previous study which showed a significantly dilated RA.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.