Assessment of proximal isovelocity surface area (PISA) shape using three-dimensional echocardiography in a paediatric population with mitral regurgitation or ventricular shunt.

Background: The proximal isovelocity surface area (PISA) method is validated to quantify mitral regurgitation (MR) and ventricular shunt (VS). However, the two-dimensional echocardiography (2DE) PISA method assumes a hemispherical distribution of velocity factors proximal to the MR or VS orifice.

Aim: To assess the PISA shape by three-dimensional echocardiography (3DE) in a paediatric population with MR or VS.