1: Obtain a Zoomed CFD of the PV in the Aortic
Arch SAX or Deep Transgastric view. If there is
a sufficiently stenosed pulmonary valve, a PISA formation
will occur. The distance from the center of
the PISA formation to it's first aliasing velocity
edge (where the color shifts from blue to red) is
the radius of the PISA formation.
2: Note the aliasing velocity. The aliasing
velocity is the velocity where if the flow exceeds
this velocity the flow will be displayed with colors
from the opposite scale.
3: Obtain a continuous wave doppler (CWD) of the
aortic valve. The CWD of the pulmonary valve
will yield a flow profile where, utilizing the calipers
(or you can trace it) to show the peak velocity.
4: Obtain an angle of the PISA formation:
The angle at the pulmonary valve is typically 180
degrees, whereas the angle at the mitral valve (for
mitral stenosis calculations) is typically 120 degrees.
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of University of Nebraska Medical Center, Center for Continuing Education and JLS Interactive, LLC.
The University of Nebraska Medical Center, Center for Continuing Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
This activity is approved by the American Society of Radiologic Technologists (ASRT) as sonography-related continuing education (CE). Credit(s) issued for successful completion of ASRT-approved CE activities are accepted by the American Registry of Diagnostic Medical Sonography, American Registry of Radiological Technologists, Cardiovascular Credentialing International and Canadian Association of Registered Diagnostic Ultrasound Professionals. Contact the applicable registry for additional information / restrictions on their acceptance of ASRT CE credit.