Evidence-based recommendations for PISA measurements in mitral regurgitation: systematic review, clinical and in-vitro study.

ABSTRACT:

Background

Guidelines for quantifying mitral regurgitation (MR) using "proximal isovelocity surface area" (PISA) instruct operators to measure the PISA radius from valve orifice to Doppler flow convergence "hemisphere". Using clinical data and a physically-constructed MR model we (A) analyse the actually-observed colour Doppler PISA shape and (B) test whether instructions to measure a "hemisphere" are helpful.

Methods and results

In part A, the true shape of PISA shells was investigated using three separate approaches. First, a systematic review of published examples consistently showed non-hemispherical, "urchinoid" shapes. Second, our clinical data confirmed that the Doppler-visualized surface is non-hemispherical. Third, in-vitro experiments showed that round orifices nev

SUBMITTER: Moraldo M 

PROVIDER: S-EPMC3819991 | biostudies-literature | 2013 Sep

REPOSITORIES: biostudies-literature