. 2021 Nov 4;23:124. doi: 10.1186/s12968-021-00814-4

Table 3.

Phase contrast suggested plane locations in patients with valvular disease, for which left heart stroke volume is needed to compute mitral regurgitation or shunt

Aortic valve status	Best plane for phase contrast forward stroke volume	Comments
No evidence of aortic disease	Ascending aorta	Ascending aorta is the easiest plane to acquire Mitral regurgitation volume = SV_VM − systolic SV_AAo
Presence of aortic stenosis without aortic regurgitation	Left ventricular outflow tract Alternatives: 1. Ascending aorta: if the flow is aligned with the vessel. Consider angle correction in case of eccentric jets 2. Right-sided phase contrast is reasonable in absence of shunt or aortic/pulmonary regurgitation	Mitral regurgitation volume = SV_VM − systolic SV_LVOT Limitation: aortic regurgitation cannot be assessed accurately using the LVOT flow If SV_AAo is used, a plane in the distal ascending aorta is preferable to minimize the effect of turbulent flow
Presence of aortic regurgitation or mixed aortic disease Need for aortic regurgitation quantification	Left ventricular outflow tract AND Ascending aorta Alternative: Single plane in the ascending aorta if the flow is aligned with the vessel. Consider angle correction in case of eccentric jets	Mitral regurgitation volume = SV_VM − systolic SV_LVOT Forward aortic SV: systolic SV_LVOT Aortic regurgitation volume: diastolic flow in the AAo If SV_AAo is used, a plane in the distal ascending aorta is preferable to minimize the effect of turbulent flow
Presence of LVOT obstruction (mitral systolic anterior motion, septal hypertrophy, sub-aortic membrane)	Ascending aorta, especially for aortic regurgitation volume Can be combined to right-sided phase contrast to confirm determine total effective SV in the absence of shunt LVOT is likely not valid for either forward or regurgitant flow	Aortic regurgitation volume: diastolic flow in the AAo Mitral regurgitation volume: SV_VM—SV_{right side}—AR volume (if no shunt); or SV_VM—systolic SV_AAo (consider angle correction if eccentric jet) If systolic SV_AAo is used, a plane in the distal ascending aorta is preferable to minimize the effect of turbulent flow Potential limitation should be acknowledged when using multiple PC planes as the risk of error increases with the number of measurements

Aortic valve status

Best plane for phase contrast forward stroke volume

Comments

No evidence of aortic disease

Ascending aorta

Ascending aorta is the easiest plane to acquire

Mitral regurgitation volume = SV_VM − systolic SV_AAo

Presence of aortic stenosis without aortic regurgitation

Left ventricular outflow tract

Alternatives:

1. Ascending aorta: if the flow is aligned with the vessel. Consider angle correction in case of eccentric jets

2. Right-sided phase contrast is reasonable in absence of shunt or aortic/pulmonary regurgitation

Mitral regurgitation volume = SV_VM − systolic SV_LVOT

Limitation: aortic regurgitation cannot be assessed accurately using the LVOT flow

If SV_AAo is used, a plane in the distal ascending aorta is preferable to minimize the effect of turbulent flow

Presence of aortic regurgitation or mixed aortic disease

Need for aortic regurgitation quantification

Left ventricular outflow tract

AND

Ascending aorta

Alternative: Single plane in the ascending aorta if the flow is aligned with the vessel. Consider angle correction in case of eccentric jets

Mitral regurgitation volume = SV_VM − systolic SV_LVOT

Forward aortic SV: systolic SV_LVOT

Aortic regurgitation volume: diastolic flow in the AAo

If SV_AAo is used, a plane in the distal ascending aorta is preferable to minimize the effect of turbulent flow

Presence of LVOT obstruction (mitral systolic anterior motion, septal hypertrophy, sub-aortic membrane)

Ascending aorta, especially for aortic regurgitation volume

Can be combined to right-sided phase contrast to confirm determine total effective SV in the absence of shunt

LVOT is likely not valid for either forward or regurgitant flow

Aortic regurgitation volume: diastolic flow in the AAo

Mitral regurgitation volume:

SV_VM—SV_{right side}—AR volume (if no shunt); or

SV_VM—systolic SV_AAo (consider angle correction if eccentric jet)

If systolic SV_AAo is used, a plane in the distal ascending aorta is preferable to minimize the effect of turbulent flow

Potential limitation should be acknowledged when using multiple PC planes as the risk of error increases with the number of measurements