Summary

• Usually presents with fatigue, dyspnoea, and lower extremity oedema. Additional complaints may include abdominal distension and early satiety.
• Mild or moderate tricuspid regurgitation without abnormal valve anatomy, ventricular function, or pulmonary artery pressure is not necessarily abnormal but is estimated to be present in over 50% of asymptomatic young adults.
• The clinically most important form is secondary to left-sided cardiac disease, with tricuspid annular dilation.
• The affected valve may be repaired or replaced; similar to mitral surgery, surgical repair is preferred over replacement.
• Operative risk for tricuspid valve operation depends on extent of right ventricular dysfunction and concomitant disease. Reoperation for severe tricuspid regurgitation after left-sided valve surgery carries a high risk. Therefore, correction of tricuspid regurgitation should be considered at the time of initial surgery.
• The disease has largely been ignored and its impact under-appreciated.