Usually presents with fatigue, dyspnea, and lower extremity edema. 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 is under appreciated.
Tricuspid regurgitation (TR) occurs when blood flows backward through the tricuspid valve. In the vast majority of patients, this occurs during systole, but severely elevated right ventricular filling pressure can be associated with diastolic TR. TR can be primary (abnormal valve morphology) or secondary (normal valve morphology). Some degree of valvular regurgitation is a quite common accidental finding in color Doppler imaging. In fact, two-dimensional echocardiography has demonstrated that 50% to 60% of asymptomatic young adults exhibit mild tricuspid regurgitation.  A smaller proportion, up to 15%, have moderate tricuspid regurgitation.
Professor of Surgery
Chairman, Division of Cardiothoracic Surgery
Department of Surgery
University of Wisconsin School of Medicine and Public Health
SAA declares that he has no competing interests.
Division of Cardiothoracic Surgery
University of Wisconsin
PT declares that he has no competing interests.
Dr Shahab A. Akhter and Dr Paul Tang would like to gratefully acknowledge Dr Kevin L. Greason, Dr Sorin V. Pislaru, and Prof. Thoraf M. Sundt III, the previous contributors to this monograph. KLG and SVP declare that they have no competing interests. TMS is an author of a reference cited in this monograph.
Assistant Professor of Medicine
Harvard Medical School
LAW declares that he has no competing interests.
Consultant Cardiothoracic Surgeon
Imperial College Healthcare NHS Trust
PPP declares that he has no competing interests.
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