10 year old female with a history of Tetralogy of Fallot, s/p valve sparing repair. Referred for cardiovascular MRI to evaluate right ventricular size and function as part of a research study. Left VentricleThe left ventricle is moderately enlarged with mildly reduced systolic function. There is diastolic flattening of the interventricular septum. The overall LV ejection fraction is 54%, the LV end diastolic volume index is 105 ml/m2, the LVEDV is 132 ml (Z-score +3.5), the LV end systolic volume index is 48 ml/m2, the LVESV is 61 ml, the LV mass index is 43 g/m2, and the LV mass is 54 g. There are no regional wall motion abnormalities present. Left AtriumThe left atrium is normal in size. Right VentricleThe right ventricle is moderately enlarged with normal systolic function. The overall RV ejection fraction is 57%, the RV end diastolic volume index is 116 ml/m2, the RVEDV is 147 ml (Z-score +3.2), the RV end systolic volume index is 50 ml/m2, and the RVESV is 63 ml. Right AtriumThe right atrium is 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 moderate pulmonary valve regurgitation. Regurgitant fraction is 30%.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.Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteriesThe main pulmonary artery is normal in size. There is discrete ostial stenosis of the left pulmonary artery. LPA receives 40% of pulmonary flow, and RPA receives 60% of pulmonary flow. MPA measures 26 x21 mm. Ostium of the LPA measures 11 x 9 mm. Distal LPA measures 14 x 13 mm. Venous AnatomyThe SVC and IVC drain normally into the right atrium. The coronary sinus appears dilated. Possible small left-sided SVC.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. Moderate left ventricular enlargement with mildly reduced systolic function. (LVEF 54%)2. Moderate right ventricular enlargement with normal systolic function. (RVEF 57%, RVEDV 116 mL/m2)3. Moderate pulmonary valve insufficiency.4. Mild left pulmonary artery ostial stenosis.5. Possible small left-sided SVC.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.