Contemporary Surgical Tricuspid Valve Repair

Q: What is the clinical evidence from this study?

Study design: Review. Population: Tricuspid valve regurgitation. Intervention: Surgical tricuspid valve repair.

Vishnu Vasanthan; Mimi Deng; Elise Chan; Adeline Chan; Daniel Goubran; Vincent Chan

doi:10.3390/jcm15156022

August 3, 2026Journal of Clinical MedicineOpen Access

Contemporary Surgical Tricuspid Valve Repair

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Key result

Surgical tricuspid repair remains safe and feasible for tricuspid regurgitation, anchored by annuloplasty.

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Why the study?

While percutaneous therapies for tricuspid regurgitation continue to advance, anatomic constraints may necessitate consideration of surgery in some patients.

Key Points

Synthesize contemporary surgical techniques, operative principles, patient selection criteria, and clinical outcomes for tricuspid valve repair.
Conducted a qualitative literature review of contemporary surgical repair strategies for primary and secondary tricuspid regurgitation.
Evaluated clinical guidelines, registries, and clinical trials examining surgical indications, including severe annular dilation (>40 mm or >21 mm/m2 indexed diameter) and concomitant left-sided cardiac operations.
Ring annuloplasty serves as the surgical gold standard, consistently demonstrating lower tricuspid regurgitation recurrence rates compared to suture annuloplasty techniques.
Concomitant tricuspid valve repair during mitral surgery was associated with reduced tricuspid regurgitation progression and death at 2 years, with a 2-year permanent pacemaker rate of 14.1%.
Reported permanent pacemaker implantation rates following tricuspid surgery were 11% in a statewide surgical cohort (N=1346), 10.3% in a long-term repair series (N=1058), and 12.7% among Medicare beneficiaries aged 65–99 years.

Structured PICO

P

Population

Patients with severe symptomatic tricuspid valve regurgitation (TR)

I

Intervention

Surgical tricuspid valve repair techniques (including annuloplasty, leaflet augmentation, and edge-to-edge repair)

Surgical tricuspid valve repair remains a durable option for severe TR, with annuloplasty as the cornerstone, while transcatheter therapies are evolving as complementary options requiring a multidisciplinary heart team approach.

Limitations

Surgical literature often includes patients with mixed-etiology TR, making it challenging to ascertain specific outcomes based on technique alone.
There are no longitudinal datasets that directly compare specific surgical repair strategies with contemporary transcatheter valve reconstruction techniques.
Lack of longitudinal datasets directly comparing specific surgical repair strategies with contemporary transcatheter valve reconstruction techniques

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Implication

May support surgical repair for severe TR; leaves open comparative trials versus percutaneous options.

Abstract

Background: Tricuspid valve surgery is indicated for severe symptomatic tricuspid valve regurgitation (TR) when performed concomitant to another cardiac operation. While percutaneous therapies for TR continue to advance, anatomic constraints may necessitate consideration of surgery in some patients. Methods: Herein, we provide a contemporary review of surgical techniques used to treat TR, which can serve as a complement to existing and emerging tricuspid valve treatment therapies. Results: We performed a literature review on established surgical tricuspid repair techniques. Conclusions: Surgical repair of the tricuspid valve is safe and feasible. While annuloplasty remains the cornerstone operative strategy, leaflet and sub-valvular techniques serve as adjuncts to help successful repair. The therapeutic paradigm for TR continues to evolve.

Discussion

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Cite This Study

Vasanthan et al. (2026) conducted a review in Tricuspid valve regurgitation. Surgical tricuspid valve repair was evaluated. Surgical repair of the tricuspid valve is a safe and feasible treatment for primary and secondary tricuspid regurgitation, with annuloplasty remaining the cornerstone operative strategy.

synapsesocial.com/papers/6a73072a226790f370658644 https://doi.org/10.3390/jcm15156022

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Contemporary Surgical Tricuspid Valve Repair

Figures

Key Points

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Contemporary Surgical Tricuspid Valve Repair

Figures

Key Points

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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