• PT-LAX is preferred (apical four-chamber if not available)
• Optimize colour gain/scale
• Identify the three components of the regurgitant jet (VC, PISA, Jet into LV)
• Reduce the colour sector size and imaging depth to maximize frame rate
• Expand the selected zone (Zoom)
• Use the cine loop to find the best frame for measurement
• Measure the smallest VC (immediately distal to the regurgitant orifice, perpendicular to the direction of the jet)

Limitations

• Not valid for multiple jets
• Small values; small measurement errors lead to large % error
• Intermediate values need confirmation
• Affected by systolic changes in regurgitant flow

Usefulness/Advantages

• Relatively quick and easy
• Relatively independent of haemodynamic and instrumentation factors
• Not affected by other valve leak
• Good for extermes AP: mild vs. severe
• Can be used in eccentric jet