الفهرس 
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Abstract
Significant TR secondary to right ventricular dilatation and dysfunction associated with mitral valve disease is a risk factor for poor functional outcome and mortality after mitral surgery. Satisfactory correction of left-sided valve disease does not assure, by itself, against the persistence or even worsening of TR, while predicting the fate of unrepaired TR remains a moot question.
On the other hand, reoperations to correct residual or recurrent TR have been associated with high operative mortality and disappointing long-term results. This all would make highly desirable that sensitive detection and liberal correction of TR be accomplished at the time of initial mitral valve surgery. Though fairly well agreed in principle, such an attitude hardly takes any uniform conversion into practice, probably due to the uncertainty as to the degree of TR that is significant enough to warrant correction. In addition, the potential for persisting TR is easily underestimated once medical therapy is upgraded following a clinical episode of failure.
A single, semi-quantitative ultrasonographic assessment of regurgitation severity, when the extremes of severity are excluded, remains a basic but probably insufficient information to this end, as it is seriously affected by a number of clinical and hemodynamic variables such as the circulating blood volume, pulmonary vascular resistances, right ventricular volume and contractility, and venous tone. Perhaps, more weight should be given to historical clinical and echocardiographic assessment of tricuspid incompetence, to the history and the severity of symptoms of right heart failure, to the drugs and dosages necessary for their control, and to objective, direct or ultrasonographic measurements such as the dimensions of the right-sided cardiac chambers and tricuspid annulus, and to descriptors of right ventricular function.