Canonical: https://echosuite.app/guides/ar-pisa/

# Aortic regurgitation PISA calculator

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

Created by [Mohammed Kamareddine, MD](https://echosuite.app/about/) · [Sources & educational scope](https://echosuite.app/about/)

[Open interactive calculator →](https://echosuite.app/calculators/#ar-pisa)

## 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](https://www.asecho.org/wp-content/uploads/2017/04/2017VavularRegurgitationGuideline.pdf)

- 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

- [Parasternal long axis acquisition guide](https://echosuite.app/guides/views/plax/) · [Open in Probe Lab](https://echosuite.app/#plax)
- [Apical five chamber acquisition guide](https://echosuite.app/guides/views/apical-five-chamber/) · [Open in Probe Lab](https://echosuite.app/#a5c)
- [Apical three chamber (apical long axis) acquisition guide](https://echosuite.app/guides/views/apical-three-chamber/) · [Open in Probe Lab](https://echosuite.app/#a3c)
- [Aortic regurgitation calculator: continuity method](https://echosuite.app/guides/ar-continuity/)
- [Mitral regurgitation PISA calculator: EROA and regurgitant volume](https://echosuite.app/guides/mr-pisa/)
- [Mitral regurgitation calculator: continuity method](https://echosuite.app/guides/mr-continuity/)
- [Tricuspid regurgitation calculator: PISA quantification](https://echosuite.app/guides/tr-pisa/)

[All echo guides](https://echosuite.app/guides/) · [Learning paths](https://echosuite.app/learn/)