Effective Regurgitant Orifice by PISA

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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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