2026 SCMR Board Exam Review Course-Session 5: Valvular Heart Disease and Congenital Heart Disease

Video Transcription

Video Summary

This session of the certification exam prep course covered CMR applications in valvular and congenital heart disease. The valvular talks emphasized that cardiac MRI is especially valuable when echocardiography is limited or discordant, and for quantifying ventricular remodeling, fibrosis, and shunt-like hemodynamics.<br /><br />For aortic stenosis, CMR can measure valve area by planimetry, assess ventricular mass/function, and detect fibrosis and infiltrative disease such as amyloidosis. For aortic regurgitation, CMR was presented as particularly strong because it directly quantifies regurgitant volume and fraction and tracks LV remodeling more reproducibly than linear echo metrics. The speakers stressed that MRI thresholds are modality-specific and should not simply copy echocardiographic cutoffs. Similar principles apply to mitral regurgitation, where CMR can outperform echo in complex or eccentric jets and help identify patients whose outcomes track with regurgitant burden and myocardial scar. Tricuspid regurgitation remains challenging, but CMR was highlighted for quantifying RV remodeling, regurgitant burden, and even systemic consequences such as liver congestion.<br /><br />The congenital heart disease lectures reviewed practical CMR protocols and core sequences: cine imaging, MR angiography, phase-contrast flow, and late gadolinium enhancement when needed. They discussed common lesions including ASD, VSD, partial anomalous pulmonary venous return, coarctation, and tetralogy of Fallot, focusing on how CMR defines anatomy, quantifies shunts (Qp:Qs), and measures ventricular size and function. Complex congenital disease, especially Fontan circulation and transposition repairs, requires a systematic approach using anatomy, flow, collateral assessment, and fibrosis imaging. The final session on shunt assessment stressed internal validation of flow data, the importance of distinguishing pre- versus post-tricuspid shunts, and the growing role of 4D flow for comprehensive, reproducible hemodynamic assessment.

Asset Caption

Joao Cavalcante: CMR for Valvular Heart Disease - 31 mins
Kanwal Farooqi: Common Congenital Heart Disease - 20 mins
Francesca Raimondi: Complex Congenital Heart Disease - 16 mins
Lars Grosse-Wortmann: Understanding Shunts on CMR - 23 mins
Roberta Catania and Michael Dilorenzo: Moderated Q&A with Speakers - 45 mins

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Keywords

cardiac MRI

CMR

valvular heart disease

congenital heart disease

aortic stenosis

aortic regurgitation

mitral regurgitation

tricuspid regurgitation

ventricular remodeling

fibrosis imaging

late gadolinium enhancement

phase-contrast flow

Qp:Qs shunt quantification

Fontan circulation

4D flow MRI