IntroductionThe decision as to whether or not concomitant tricuspid valve (TV) surgery should be performed in patients with left-sided valve surgery was influenced for many years by an article from Braunwald et al in 1967. 1 In this article, the authors concluded that tricuspid regurgitation (TR), in the presence of concomitant mitral valve (MV), would "… improve or disappear after MV replacement and that TV replacement is seldom necessary."However, several publications in the past 10 years have demonstrated that up to 74% of patients undergoing successful left-sided valve surgery will develop TR over time with poor outcomes. [2][3][4][5] In addition, TV-related reoperation is associated with an early mortality rate ranging between 0 and 37%.