To estimate more precisely the systolic pulmonary artery pressure (PASP), continuous wave Doppler pressure gradient method and catheter measurement were performed simultaneously in 85 patients. There were 30 patients with tricuspid regurgitation (TR), 35 with ventricular septal defect (VSD), and 20 with patent ductus arterosus (PDA). For maximal transtricuspid pressure gradient (TRPG) determined by continuous wave Doppler and catheter determined PASP in TR group, the correlation coefficient (r) was as high as 0.99. For Doppler determined PASP (subtracting pressure gradient across PDA from systemic arterial pressure measured by cuff sphygmomanometer) and catheter determined PASP in PDA group, r was 0.95. Doppler determined PASP in VSD group (subtracting pressure gradient across VSD from systemic arterial pressure) also correlated well with catheter determined PASP (r = 0.97). This study demonstrates that continuous wave Doppler pressure gradient method can accurately estimate PASP in patients with TR, PDA, and VSD.