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Indications for Surgery : Patients with moderate or severe tricuspid regurgitation that is functional will need tricuspid annuloplasty at the time of correction of mitral valve disease. Such patients will have pulmonary arterial and right ventricular pressure above 55mm of Hg. At the time of mitral valve surgery, mild tricuspid regurgitation may be left alone as in these patients regression of pulmonary arterial hypertension after correction of mitral valve pathology will make tricuspid valve 1 more competent. Moderate and severe regurgitation will have to be repaired at the time of mitral valve surgery, for better immediate and long-term results.
In organic tricuspid regurgitation, the pulmonary artery pressure is usually less than 40mm of Hg. If the tricuspid regurgitation is severe, surgery is required in the form of valve replacement, It is better to put a bio prosthetic valve in the tricuspid position.
Endocarditis in drug addicts may be the cause of tricuspid regurgitation. They tolerate complete excision (valvectomy) without replacement, if other cardiac valves are normal and there is no pulmonary hypertension. After about six months, when there is no danger of infection, tricuspid replacement wit11 a bio prosthetic valve could be done.
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