Key result
PISA provides effective quantitative mitral regurgitation assessment to guide intraoperative clinical decision-making.
Why the study?
The clinical utility and methodology of proximal isovelocity surface area (PISA) measurement for intraoperative evaluation of mitral regurgitation require comprehensive review and standardization.
Answers are grounded in this paper and cite their sources.
The proximal isovelocity surface area (PISA) measurement, also known as the "flow convergence" method, can be used in echocardiography to estimate the area of an orifice through which blood flows. It has many applications, but this review focuses only on its use in the intraoperative evaluation of mitral regurgitation. In that setting, PISA provides a quantitative assessment of the severity of mitral regurgitation and it is useful in clinical decision-making in the operating room. In this review, I discuss the physical principles behind the PISA method, along with the various mathematical formulas used to calculate the effective mitral regurgitant orifice area, the regurgitant volume, and the regurgitant fraction. A step-by-step approach is presented and illustrated with graphic and video demonstrations. Finally, I will discuss the various limitations and technical considerations of PISA measurement in the operating room.
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A 2007 study conducted a review in Mitral Regurgitation. Transesophageal echocardiography and proximal isovelocity surface area (PISA) measurement was evaluated. The proximal isovelocity surface area measurement provides a quantitative assessment of the severity of mitral regurgitation and is useful in clinical decision-making in the operating room.
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