الفهرس 
Anatomy and physiology of the tricuspid valveOnly 14 pages are availabe for public view
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Abstract
Although significant tricuspid regurgitation is associated with increased morbidity and mortality. The concept that secondary tricuspid regurgitation decreases after left sided surgery alone has led to functional tricuspid regurgitation being ignored or under treated . however surgically untreated tricuspid regurgitation can persist or even worsen despite correction of the associated left sided valve pathology suggesting that a more aggressive approach towards this disease should be advocated weather preoperative tricuspid regurgitation will regress or progress late after surgery is unknown .
The result showed that the tricuspid regurgitation is improved postoperatively weather the repair was done or not but Statistically the differences between group A and group B were significant.
Considering our part of world were most of patients are suffering from rheumatic valvular heart diseases. Our patient population is usually younger age group with longer life expectancy. Therefore they are more prone to RV failure if their TR fails to regress. Therefore on expenditure of few more minutes we correct their TR it will save them from possible future RV failure .There is growing consciences to correct moderate TR. So moderate tricuspid regurgitation due to left sided valve diseases should be treated to improve patient outcomes by giving benefit of doubt to prevent regurgitation progression and RV dysfunction .Because of inability to predict which patients will develop significant tricuspid regurgitation after correction of the left sided lesion , because of the limited effectiveness of surgical therapy for tricuspid regurgitation occurring after left sided surgery due to the high mortality of redo surgery and as tricuspid annuloplasty adds only short time to cardiopulmonary bypass and aortic cross clamp even it may be done after release of the cross clamp and dosent add significantly to perioperative morbidity and mortality , a more aggressive approach towards tricuspid valve repair is recommended .
De Vega annuloplasty is a safe , efficacious , inexpensive method that avoid the use of a foreign material in repairing the tricuspid valve regurgitation .
Recently , it is evident that tricuspid annular dilatation predispose to the late development of tricuspid regurgitation , so tricuspid annular dilatation should be used as an indication of tricuspid valve repair. Assessing for tricuspid valve annular dilatation can be recommended in all mitral valve procedure , as identifying and treating annular dilatation may be associated with superior long term outcomes.