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Regurgitant Fraction by PISA
Calcs>Aortic Regurgitation>RF by PISA>1
SVAV = CSALVOT x VTIAV
SVAV = 0.785 x DLVOT2 x VTIAV
RVAR = EROAR x VITAR
RVAR = ((2 x pi x r2 x VA x alpha/ 180) / Vmax) x VTIAR
RFAR = RVAR / SVAV
to get a Regurgitant Volume in Aortic Regurgitation.
Step 1: Obtain
a CFD of the AR Jet with a good PISA formation under
zoomed view. The DTG AVLAX, TG AVLAX,
or ME AVLAX views should provide a good PISA formation.
The DTG view is optimal for the CWD mode also.
2: Measure the Diameter of the PISA radius.
The radius is from the center of the PISA formation,
typically from the center of the valve, to the first
aliasing velocity. If the PISA is small, try
slightly decreasing the aliasing velocity (VA) which
will increase the size of the PISA formation.
3: Obtain a VTI of the Regurgitant Jet by CWD.
From the flow profile the Vmax and the
VTI of the regurgitant jet can be obtained by tracing
the diastolic flow profile.
4: Obtain the angle of the PISA formation.
The angle is typically 180 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.