PISA: Tips, Tricks & More
Quantifying Mitral Regurgitation like an Expert
Why is PISA Important?
As the popularity of non-invasive echocardiography continues to grow, many clinical teams are aiming to use quantitative methods to grade abnormal findings as opposed to qualitative methods. Quantitative data is numerical and measurable whereas qualitative refers to descriptive, non-numerical information such as visual estimations or words.
Mitral regurgitation (MR) is a common and essential condition for cardiovascular sonographers to understand. It can be classified into two types: primary (or degenerative) and secondary (or functional). Primary MR occurs when there are structural abnormalities in the components of the mitral valve apparatus—such as the chordae tendineae, leaflets, annulus, papillary muscles, or the underlying myocardium—that lead to a leak. In contrast, secondary MR arises from ventricular dilation or regional wall motion abnormalities that affect the mitral valve's function, even though its structure may remain intact.
What is PISA?
Proximal isovelocity surface area (PISA) is a method used to quantify the effective regurgitant orifice area (EROA) and the regurgitant volume (RVol) of the retrograde jet. In today’s lesson we will walk you through a sample case and teach you the strengths and limitations of PISA to quantify MR severity. Take your echo expertise to new heights—become a premium member and start mastering advanced techniques now.