Summary
Conclusions
In the absence of clinical trials, present guidelines are based on expert opinion. The surgical indications for TR are considered more actively if:
- Another cardiac operation is considered, especially at the time of left-sided valve surgery.
- If functional TR is severe, particularly based on quantitative criteria such as ERO ≥40 mm2.
- When the patient is symptomatic from the TR, especially with congestive signs directly related to the TR, or marked reduction of functional capacity measured without other cause than the TR.
Nevertheless, it is essential to consider surgery only if the co-morbid conditions are not overwhelming, RV dysfunction is not irreversible, and life expectancy is at least several years.
