Regurgitant Fraction by PISA
Tricuspid Regurgitation
· Dr. Kenneth Gross ·
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Calcs>Tricuspid Regurgitation>RF by PISA>1
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Radius
cm
Jet VTI cm
Vmax m/sec
VA cm/sec
Angle degrees
TV Diameter cm
TV VTI cm
 
ERO cm2
RV mls
SV mls
RF %

 

Formulas:

ERO = 2 * pi * r2 * VA * angle / 180 / Vmax

RV = ERO * RJ-VTI

SV = 0.785 * TV Diameter2 * TV-VTI

RF = RV / SV

 
How to get a Regurgitant Fraction in Tricuspid Regurgitation.
 
Step 1:  Obtain a CFD of the TR Jet with a good PISA formation under zoomed view.  The ME 4CV, ME RVIO, or ME BCV with the best and largest PISA formation should be used.
 
Step 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.
 
Step 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.
 
Step 4: Obtain the angle of the PISA formation. The angle is typically 180 degrees.
 
Step 5: Obtain the Diameter of the Ticuspid Valve.
 
Step 6: Obtain the VTI of the Tricuspid Valve by CWD.
 

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