44 year old male with hx of bicuspid aortic valve, s/p valvuloplasty, s/p aortic valve replacement. Last ascending aorta measurement 49mm. Evaluate ascending aorta, para-valvar leak, LV size and function. Left VentricleThe left ventricle is normal in size with normal systolic function. The overall LV ejection fraction is 53%. The LVEDV is 191 ml (normal range 142+/-34), the LV end diastolic volume index is 113 ml/m2 (normal range: 74+/-15), the LVESV is 89 ml (normal range 47+/-19) and the LV end systolic volume index is 53 ml/m2 (normal range 25+/-9). The LV mass is 113 g (normal range 164+/-36) and the LV mass index is 67 g/m2 (normal range 85+/-15). 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.The native T1 myocardial relaxation time is <1000 ms suggestive of absence of underlying diffuse fibrosis or infiltration. There is no myocardial iron overload. Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is mildly dilated with normal systolic function. The overall RV ejection fraction is 52%. The RVEDV is 214 ml (normal range 142+/-31), RV end diastolic volume index is 127 ml/m2 (normal range 82+/-16), the RVESV is 103 ml (normal range 54+/-17), and the RV end systolic volume index is 61 ml/m2 (normal range 31+/-9).Right AtriumThe right atrium is normal in size.Aortic ValveThe mechanical aortic valve is in good position with mild regurgitation (regurgitant fraction 14%). Location of regurgitation can not be determined due to valve-related artifact. Mitral ValveThe mitral valve opens widely and there is mild mitral regurgitation.Pulmonic ValveThe pulmonic valve opens widely. There is no significant 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. The maximum dimension of the ascending aorta is 41 mm (mildly dilated). There is no coarctation noted.Sinus of Valsalva: 38x35mmST Junction: 35x34mmAscending Ao (4.5cm from Ao Annulus): 41x39mmProximal Arch: 32x36mmMid Arch: 25x25mmDesc Thoracic Ao: 22x24mmPulmonary 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 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.Normal sized LV with normal systolic function, LVEF 53% without evidence of underlying myocardial fibrosis, inflammation, or infiltration .2.Mildly dilated RV with normal systolic function, RVEF 52%.3.Mild mechanical aortic valve regurgitation.4.The ascending aorta is mildly dilated (41mm). When remeasured on prior CT scan, there is no change in aorta size. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.