PISA Calculator

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Regurgitation mode computes EROA and regurgitant volume. Stenosis mode adds the angle correction to derive mitral valve area.
Radius of the hemispheric flow-convergence zone, measured from the color aliasing boundary to the vena contracta at mid-systole. Typical range 0.3-1.5 cm.
cm
Color Doppler baseline-shift velocity at which aliasing occurs. ASE recommends 20-40 cm/s for optimal hemispheric PISA.
cm/s
Peak continuous-wave Doppler velocity of the jet: the regurgitant jet in MR mode (typically 400-600 cm/s) or the diastolic mitral inflow jet in stenosis mode (typically 150-250 cm/s). Enter in cm/s (multiply m/s by 100).
cm/s
Velocity-time integral of the complete mitral regurgitant jet envelope traced by continuous-wave Doppler. Typical range 100-200 cm.
cm
EROAModerate-Severe
0.32cm²

Effective regurgitant orifice area

Volume flow rate (VFR)160.8mL/s
EROA (mm²)32.2mm²
Regurgitant volume (RVol)48.3mL/beat
PISA surface area4.021cm²
MR severityModerate-Severe
32.2 mm²
Mild<20Mild-Moderate20-30Moderate-Severe30-40Severe40+

Moderate-Severe mitral regurgitation - EROA 32.2 mm², RVol 48.3 mL/beat.

  • EROA of 32.2 mm² and RVol of 48.3 mL/beat indicate moderate-severe mitral regurgitation by ASE criteria.
  • Moderate MR should be followed with serial echocardiography and clinical review. Symptoms, LV size, and ejection fraction guide timing of intervention.
  • PISA is a single-frame estimate and assumes hemispheric geometry. Integrate with vena contracta width, pulmonary vein flow, and LV/LA dimensions for a complete assessment.

Next stepContinue integrative echo assessment. Confirm with vena contracta width and pulmonary vein systolic flow reversal.

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