“…Its application has been confined to different intracardiac shunts and valvular lesions. 4 Although PISA was used for estimating the orifice area of the pulmonary vein in a patient with concomitant PVS and atrioventricular septal defect, 9 our report further substantiates this method by correlating with the computed tomography–derived diameter of the RUPV opening. In addition, the operating surgeon could pass only a 1.5-mm shunt across the RUPV, confirming the PISA-derived values.…”