Tricuspid valve disease: pathophysiology and optimal management.

Tricuspid valve disease most commonly occurs secondary to left-sided heart valve disease, in particular mitral valve disease. It is a marker of adverse outcome, and patients with moderate or severe tricuspid regurgitation (TR) have a reduced survival rate. Primary TR is treated surgically if severe, and the patient is symptomatic. However, during concomitant left-sided heart valve surgery, moderate or severe secondary TR with either raised pulmonary artery pressures or tricuspid annular dilatation should also be treated. This article reviews the pathophysiology and current management of patients with tricuspid valve disease.