Effective Regurgitant Orifice by PISA
Tricuspid Regurgitation
· Dr. Kenneth Gross ·
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Calcs>Tricuspid Regurgitation>ERO by PISA>1
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Radius
cm
Jet VTI cm
Vmax m/sec
VA cm/sec
Angle degrees
 
ERO cm2

 

Formulas:

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

 
How to get a Regurgitant Volume 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.
 

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