Effective Regurgitant Orifice by PISA
Pulmonary Regurgitation
· Dr. Kenneth Gross ·
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Calcs>Pulmonary Regurgitation>ERO by PISA>1
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PISA Radius (r)(cm): cm
Aliasing Velocity (VA cm /sec
Vmax (m/sec) m/sec
Angle ( degrees
 
ERO cm2









 
Formula:  ERO = 2 * pi * r2 * VA * angle / 180 / Vmax
 
How to get an ERO in PR.
 
Step 1: Obtain a Zoomed CFD of the PV. In AR, 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.
 
Step 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. 
 
Step 3: Obtain a continuous wave doppler (CWD) of the pulmonic valve.  The CWD of the pulmonic valve will yield a flow profile where, utilizing the calipers (or you can trace it) to show the peak velocity. 
 
Step 4: Obtain an angle of the PISA formation: The angle at the mitral valve is typically 120 degrees, whereas the angle for the aortic or pulmonic valve is typically 180 degrees.
 

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