Surgical Treatment of Secondary Tricuspid Regurgitation: Insight Derived From Annulus Sizes and Tethering Distances

The evaluation of both tricuspid annular diameter and tethering distance may help clinicians to stratify patients with secondary TR into different risk levels as a means of choosing an optimal TVP approach. The application of a modified De Vega procedure or an undersized annuloplasty ring in patients within appropriate risk level could improve the treatment for secondary TR.