Results of tricuspid valve surgery for functional tricuspid regurgitation: acute and long-term outcomes and predictors of failure

: The assessment and management of tricuspid valve (TV) disease evolved significantly in the last decade. Tricuspid regurgitation (TR) is a frequent heart valve disease and it is most often secondary, due to annular dilatation and leaflet tethering from right ventricular remodeling. The indications for TV surgery are several and mainly related to the underlying disease, to the severity of the regurgitation and to the right ventricular function. Moreover, surgical tricuspid repair has been avoided for years, because of the erroneous concept that TR should disappear once the primary pathology on the left heart has been resolved. Instead, during the last few years, many investigators have reported evidence in favor of a more aggressive surgical approach to functional TR, recognizing the risk of progressive tricuspid insufficiency in patients with annular dilatation and only moderate regurgitation (or less) at the time of surgery. This concept, along with the acute and long-term outcomes of tricuspid surgical repair techniques and tricuspid replacement are discussed in this review.