What are the causes of tricuspid valve lesions? Mild tricuspid insufficiency can be seen in normal individuals. Severe tricuspid insufficiency is a pathologic change. The causes include both primary and secondary lesions, with more secondary factors than primary lesions. Secondary lesions are most often seen in tricuspid annulus enlargement or increased right ventricular load due to mitral valve lesions, and in a few cases can be secondary to primary pulmonary hypertension. Primary lesions can be congenital tricuspid leaflet subluxation or tendon deficiency, or structural damage to the tricuspid valve due to trauma or infection. Tricuspid stenotic lesions are almost always rheumatic, and rarely are congenital. What tests are needed for tricuspid valve lesions? Routine tests include electrocardiogram, frontal and lateral chest x-ray, cardiac ultrasound, and appropriate blood tests. The focus of the examination includes: tricuspid valve lesions, right ventricular function and left atrioventricular valve lesions; the right ventricular function is the most difficult part of the examination, and some patients require cardiac MRI to determine the right heart function. What is the progression of tricuspid valve lesions? Patients with tricuspid valve lesions, whether incomplete or stenotic, can often tolerate them for a long time, but the prognosis for severe tricuspid valve lesions is poor. Risk factors for progression include pulmonary hypertension, increased right ventricular pressure and chambers, decreased right ventricular function, atrial fibrillation, placement of a permanent pacemaker, and the degree of tricuspid valve remodeling (annular enlargement and leaflet-to-edge height). What are the indications for surgical treatment of tricuspid valve lesions? Patients with symptomatic severe tricuspid stenosis or severe tricuspid insufficiency without impairment of right heart function require aggressive surgical treatment (Class I recommendation); left heart valve surgery with severe tricuspid stenosis or insufficiency requires concurrent aggressive treatment (Class I recommendation); left heart valve surgery with moderate tricuspid insufficiency requires concurrent tricuspid treatment (Class IIa recommendation); left heart valve surgery with mild or moderate tricuspid insufficiency requires concurrent treatment (Class IIa recommendation) patients with asymptomatic or mildly symptomatic severe primary tricuspid insufficiency who present with progressive right ventricular enlargement or reduced right ventricular function require surgical treatment (Class IIa recommendation); patients with severe tricuspid insufficiency after left heart valve surgery who are symptomatic or present with progressive right ventricular enlargement or reduced right ventricular function require surgical treatment (Class IIa recommendation); patients with severe tricuspid insufficiency after left heart valve surgery require surgical treatment (Class IIa recommendation); patients with severe tricuspid insufficiency who present with progressive right ventricular enlargement or reduced right ventricular function require surgical treatment (Class IIa recommendation) Patients who are symptomatic or present with progressive right ventricular enlargement/reduced function, no abnormal left valve function, no abnormal right or left ventricular function, and no patients with severe pulmonary vascular disease require surgical treatment of tricuspid valve lesions (Class IIa recommendation). What is the outcome of surgical treatment of tricuspid valve lesions? Most tricuspid valve insufficiency can be repaired with a shaping procedure. The key point of the shaping technique is the application of a shaping ring, which provides significantly better treatment results than other techniques. In patients with tricuspid valve insufficiency and severe tricuspid stenosis due to right ventricular hyperdilation, replacement of a large bioprosthetic valve should be the better option. Patient survival rates at 10 years range from 30-50%, with patient preoperative functional status, right and left ventricular function, and valve-related complications being the main influencing factors. The surgical risk of tricuspid valve insufficiency following mitral valve replacement is higher, and the risk is mainly related to the patient’s preoperative systemic status and right heart function status. What medications are used to treat tricuspid valve lesions? Drug therapy relies primarily on diuretics, with other aspects of medication determined by symptoms.