Forgotten tricuspid valve? In cases of severe regurgitation, I prefer early surgery

After decades of neglect, awareness of the clinical importance of tricuspid regurgitation has recently increased, partly due to the expansion of transcatheter therapies. Historically, tricuspid valve surgery has been associated with high operative mortality, primarily because patients were referred late, often presenting with right ventricular dysfunction and end-organ damage. However, more recent reports demonstrate excellent surgical outcomes when procedures are performed in appropriately selected patients without right ventricular impairment or organ dysfunction. In the setting of severe tricuspid regurgitation, early referral for correction of the valvular defect-before the onset of right ventricular dysfunction-is essential to achieve low operative mortality and favourable long-term prognosis.