In the majority of patients (70–85%), the TR is said to be “functional”, caused by dilatation of the annulus as a result of increased pulmonary and right ventricular pressure; in the remaining 15–30% of the cases it may be organic and related to direct involvement of the tricuspid valve by the rheumatic disease.1,2 

Whichever type, TR has a significant impact on the clinical condition and the medium and long‐term prognosis of the patients. Hence, it requires special consideration during mitral and/or aortic valve surgery and thereafter.

Even moderate TR observed during surgery of left heart valves may not regress spontaneously, especially when there is already a degree of right ventricular dysfunction indicated by annular dilatation. In their experience with patients who were subjected to valvuloplasty for mitral valve regurgitation, Dreyfus et al4found that the tricuspid annulus was abnormally dilated in about 50% of the patients, even in the absence of TR.