The Price of Freedom from Tricuspid Regurgitation

Progressive tricuspid regurgitation is common, particularly in patients undergoing mitral-valve surgery. Severe tricuspid regurgitation decreases survival and quality of life due to right ventricular dysfunction, congestive hepatopathy, and renal failure. The tricuspid valve can easily be repaired during mitral-valve surgery, and consensus guidelines recommend concomitant repair of mild or moderate tricuspid regurgitation with annular dilatation of 4.0 cm or more.1 However, these recommendations are based on mostly observational data, and controversy surrounds the most effective strategy, which contributes to wide variation in practice: concomitant tricuspid repair rates at cardiac surgery programs in the United States range from under 5% to . . .