Tricuspid valve insufficiency is mostly caused by pulmonary hypertension and tricuspid valve dilatation. The cause of tricuspid valve insufficiency is classified as functional or organic depending on whether the tricuspid valve is structurally normal or not, and two different types of tricuspid valve insufficiency sometimes coexist. Tricuspid valve insufficiency can be treated with valvuloplasty and valve replacement. Numerous clinical reports confirm that Carpentier’s approach to valvuloplasty is more effective. Functional tricuspid valve insufficiency is mainly due to chronic insufficiency of the left side of the heart due to heart disease, increased pressure in the left atrium, increased pressure in the pulmonary artery, and increased pressure in the right ventricle resulting in tricuspid regurgitation. However, long-term functional tricuspid valve insufficiency also results in anatomic changes due to expansion of the tricuspid annulus. The clinical manifestations of tricuspid insufficiency are very similar to those of tricuspid stenosis, showing clinical signs of bruising in the circulation, ascites, hepatic congestion, bilateral lower extremity edema, and decreased left ventricular excretion due to left heart preload deficit. Simple tricuspid insufficiency should be treated surgically if there is significant enlargement of the right atrium and stasis of the body circulation. Functional tricuspid valve insufficiency should be corrected at the same time as left-sided heart surgery is performed. Many studies have demonstrated that aggressive correction of functional tricuspid valve insufficiency facilitates a smooth postoperative recovery, increases antegrade right heart drainage, and increases the amount of blood returned to the left side of the heart. If there is an elevated pulmonary artery pressure prior to surgery, it is usually associated with tricuspid valve insufficiency. Preoperative cardiac ultrasound and active intraoperative exploration of the tricuspid valve should be performed to correct any dilated tricuspid annulus or moderate or greater insufficiency. The majority of tricuspid valve insufficiencies, whether functional or organic, can be corrected by tricuspid valvuloplasty, but severe tricuspid valve lesions that cannot be corrected by tricuspid valvuloplasty require tricuspid valve replacement. The choice of the specific surgical procedure will vary from person to person.