Aortic regurgitation PISA calculator

Review the PISA inputs and Doppler acquisition guidance used to quantify aortic regurgitation.

Created by Mohammed Kamareddine, MD · Sources & educational scope

Method

EROA = 2πr²Vₐ ÷ Vmax; RVol = EROA × VTI

Use the measurement units shown below. Some fields apply only to a selected method or condition; follow the interactive tool’s method choices. The interactive tool keeps missing measurements incomplete and provides its method-specific results and reference context.

Measurements and acquisition

PISA radius cm

Color Doppler · peak-flow frame

Zoom on the valve and center the flow-convergence region.
Shift the color baseline until the shell is as hemispheric as possible.
Measure from the regurgitant orifice to the first aliasing boundary along the jet centerline.

Aliasing velocity cm/s

Shifted color scale · absolute cm/s

Use the same color-Doppler frame used for the radius.
Read the Nyquist limit after baseline shift, not the jet velocity.
Enter the absolute displayed value in cm/s.

AR Vmax m/s

Continuous-wave Doppler

Align the CW cursor as parallel as possible to the jet.
Acquire a dense, complete envelope without truncation.
Measure the highest absolute velocity on the selected envelope.

AR VTI cm

Continuous-wave Doppler trace

Use the same aligned CW recording as the peak velocity.
Trace the outer edge of the dense envelope for the relevant phase.
Use the machine-reported VTI in centimeters.

LVOT stroke volume mL

Enter the measured value in the displayed unit

Confirm the variable matches the selected formula.
Use the unit displayed beside the field.
Keep measurements from the same representative hemodynamic state.

Sources and method context

American Society of Echocardiography · 2017 · Recommendations for Noninvasive Evaluation of Native Valvular Regurgitation · AR PISA and flow-convergence method pp. 34–39 · Table 10 pp. 35–37 · Table 11 p. 38 · Figure 21 p. 39 · integrative pathway pp. 41–42

Primary reference

Equation, phase & acquisition · AR section p. 34 · Table 10 pp. 35–37 · Figure 21 p. 39
Early-diastolic radius and peak AR velocity pairing, baseline shift, CW peak/VTI acquisition, and the EROA and regurgitant-volume equations.
Quantitative grades · Table 11 · PDF p. 38
Four quantitative EROA, regurgitant-volume, and regurgitant-fraction bands, including the two moderate subgrades.
Limitations & severity integration · AR section pp. 34–37 · integrative approach pp. 41–42
Far-field and calcification limitations, nonhemispheric or multiple-jet limitations, and integration with anatomy, vena contracta, aortic flow reversal, LV remodeling, hemodynamics, and data quality.

Catalogue review status: Exact guideline locator mapped · clinical sign-off pending

These pages describe the educational tool. Interpret measurements with the complete clinical context and the method’s acquisition limitations.

Keep exploring

All echo guides · Learning paths