Surgery of the Tricuspid Valve

Systemic cardiac output is determined by delivery of blood through the lungs to the left atrium. In turn, transpulmonary blood flow is dependent upon competent non-obstructive pulmonary and tricuspid valves and the pulmonary vascular resistance. Whilst pulmonary valve anomalies are predominantly congenital in origin, the tricuspid valve mirrors the mitral valve in being subject to degenerative or inflammatory disease [1–3]. Because right ventricular afterload is substantially lower than left ventricular afterload, tricuspid regurgitation may be well tolerated for many years [4]. Nevertheless, it is a mistake to underestimate the significance of tricuspid pathology at the time of left heart surgery [5, 6].