48 year old woman with history of aortic coarctation repair, referred for cardiac MRI for interval assessment of repair. Left VentricleThe left ventricle is normal in size with normal systolic function. The overall LV ejection fraction is 58%, the LV end diastolic volume index is 64 ml/m2 (normal range: 65+/-11), the LVEDV is 153 ml (normal range 109+/-23), the LV end systolic volume index is 27 ml/m2 (normal range 18+/-5), the LVESV is 64 ml (normal range 31+/-10), the LV mass index is 41 g/m2 (normal range 67+/-11), and the LV mass is 98 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.Left AtriumThe left atrium is mildly dilated. Right VentricleThe right ventricle is normal in size with normal systolic function. The overall RV ejection fraction is 62%, the RV end diastolic volume index is 66 ml/m2 (normal range 69+/-14), the RVEDV is 155 ml (normal range 110+/-24), the RV end systolic volume index is 25 ml/m2 (normal range 22+/-8), and the RVESV is 58 ml (normal range 35+/-13). Right AtriumThe right atrium is mildly dilated. Aortic ValveThe aortic valve is tri-leaflet and opens widely. There is mild 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 opens widely. There is mild tricuspid regurgitation.AortaThe aortic arch vessels are in a bovine configuration (i.e. the innominate artery gives rise the the left carotid artery, right carotid artery, and the right subclavian artery). There are no focal aortic aneurysms or dissection in the thoracic aorta. There appears to be a stenosis of the proximal left carotid artery; however, the area is contaminated by imaging artifact, recommend correlation with exam or a dedicated carotid ultrasound study. There is evidence of an end-to-end coarctation repair of the descending aorta. A mild residual aortic coarctation is noted just distal to the left subclavian artery. There is mild flow acceleration through the narrowed region. The descending aorta is mildly enlarged. The aortic measurements are:Sinus of Valsalva: 33x34x35 mmST Junction: 25x26mmAscending aorta (proximal to innominate artery): 27x27mmDescending aorta proximal to coarctation: 24x24mmAortic coarctation: 20x20mmDescending thoracic aorta distal to coarctation: 28x26mmDistal descending thoracic aorta: 24x23mmPulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is mildly dilated.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.
1. The left ventricle is normal in size with normal systolic function. The overall LV ejection fraction is 58%. 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 normal systolic function. The overall RV ejection fraction is 62%.3. There is evidence of an end-to-end aortic coarctation repair. There is a mild residual descending aortic coarctation (minimum diameter 20x20mm) with mild dilation just proximal and distal to the coarctation. The dimensions are listed above. There are no focal aneurysms or dissections of the thoracic aorta. 4. Mild biatrial dilation.5. Mild main pulmonary artery dilation.6. Can not exclude stenosis of proximal left carotid artery, recommend correlation with vascular ultrasound study if clinically indicated. 7. Overall, there is no significant change in aortic dimensions or ventricular function since prior MRI on 3/15/2010.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.