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Functional or secondary tricuspid regurgitation commonly is found in the setting of left-sided heart disease and, when severe, is associated with substantially poorer functional outcomes and survival if untreated. The traditional view that functional tricuspid regurgitation generally resolves with surgical correction of the primary lesions is no longer held. Data showing late development of severe tricuspid regurgitation in patients with mild regurgitation at time of mitral valve surgery have heralded a new era of aggressive intervention on the tricuspid valve. Tricuspid ring annuloplasty can be performed with minimal incremental morbidity and negligible additional mortality. Therefore, in addition to patients with severe regurgitation, annuloplasty is now also recommended for patients wit…

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