88 year old woman with history of aortic aneurysm repair in 2009 now with enlarged aortic root on transthoracic ultrasound who presents for cardiac MRI for further evaluation of thoracic aorta size and morphology Left VentricleThe left ventricle is normal in size with mildly reduced systolic function. The overall LV ejection fraction is 46%%, the LV end diastolic volume index is 84 ml/m2 (normal range: 65+/-11), the LVEDV is 183 ml (normal range 109+/-23), the LV end systolic volume index is 45 ml/m2 (normal range 18+/-5), the LVESV is 98 ml (normal range 31+/-10), the LV mass index is 28 g/m2 (normal range 67+/-11), and the LV mass is 61 g (normal range 114+/-24). There is diffuse hypokinesis.Left AtriumThe left atrium is moderately dilated. Right VentricleThe right ventricle is normal in size with mildly reduced systolic function. The overall RV ejection fraction is 40%%, the RV end diastolic volume index is 69 ml/m2 (normal range 69+/-14), the RVEDV is 150 ml (normal range 110+/-24), the RV end systolic volume index is 41 ml/m2 (normal range 22+/-8), and the RVESV is 90 ml (normal range 35+/-13). Right AtriumThe right atrium is moderately dilated. Aortic ValveThe aortic valve opens widely and there is at least mild to moderate aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is mild mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is trivial significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is no significant tricuspid regurgitation.AortaAortic graft material is noted in the proximal ascending aorta, without concomitant findings to suggest infection. There is a left sided aortic arch with a normal brachiocephalic branching pattern. The aortic root is dilated.Annulus: 23 x 33 mmSOV: 54 x 46 x 49 mmAsc Ao (4 cm from annulus): 32 x 32 mm (in the region of the aortic graft) however dilates to 39 mm just beyond the aortic graft.Aortic arch: 41 x 42 mmDescending Ao: 35 x 39 mmPulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is dilated, measuring 39 mm. Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium. PericardiumThere is no obvious pericardial disease.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. There are small renal and hepatic hyperintense lesions, statistically representing cysts. Small pleural effusions are present.
1. The left ventricle is normal in size with mildly reduced systolic function[LVEF 46%]2. The right ventricle is normal in size with mildly reduced systolic function [RVEF 40%]3. Dilated thoracic aorta as noted above, most severe at the sinus of Valsalva4. Dilated pulmonary artery 5. At least moderate aortic regurgitation