Tricuspid valve repair illustration

Second Chance for Your Heart: Understanding Tricuspid Valve Repair After Mitral Valve Surgery

Beau Callahan in Health & Wellness November 2025 • 4 min read.

"Is your tricuspid valve giving you trouble after mitral valve surgery? Learn about the causes, solutions, and why a second surgery might be the best thing for your heart."

If you've had mitral valve surgery, you might think your heart troubles are over. Unfortunately, some patients develop tricuspid valve regurgitation (TR) later on. This means the tricuspid valve, which controls blood flow between the heart's upper and lower right chambers, doesn't close properly, causing blood to leak backward. While the leaflets of the tricuspid valve itself are usually normal, the whole valve malfunctions due to the pressure overload on the right ventricle.

For years, doctors believed this TR would improve on its own after mitral valve surgery, addressing the primary issue. However, it became clear that in many cases, the tricuspid valve needed its own dedicated repair to fully restore heart function. Ignoring TR can have serious consequences, even becoming life-threatening.

Today, medical guidelines recognize the importance of addressing TR, especially if it's severe or if the valve annulus (the ring around the valve) is significantly dilated. If you're facing this situation after mitral valve surgery, know that you're not alone, and effective solutions exist.

Why Does This Happen? Understanding Secondary Tricuspid Regurgitation

Tricuspid regurgitation that occurs after mitral valve surgery is typically classified as "secondary." This means it isn't caused by a problem with the tricuspid valve itself, but rather by other issues in the heart. The primary culprit is long-standing left-sided valve failure, which puts extra pressure on the right side of the heart, leading to:

It’s important to remember that TR can develop years after your initial mitral valve surgery. Keep an eye out for symptoms and maintain regular check-ups with your cardiologist.

Annular Dilation: The tricuspid valve annulus widens, making it harder for the valve leaflets to meet properly.
Right Ventricle Enlargement: The right ventricle stretches and changes shape to cope with the increased workload, further distorting the valve.
Leaflet Tethering: The valve leaflets become restricted, unable to close fully.

Unfortunately, many patients don't experience symptoms until the condition is advanced. Be aware of these potential warning signs:

A Brighter Future for Your Heart

If you're experiencing TR after mitral valve surgery, remember that effective treatments are available. Don't hesitate to discuss your concerns with your cardiologist and explore the best course of action for your individual situation. With careful evaluation, timely intervention, and a dedicated medical team, you can reclaim your heart health and enjoy a better quality of life.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

Everything You Need To Know

What is tricuspid valve regurgitation (TR), and why might it occur after I've already had mitral valve surgery?

Tricuspid valve regurgitation (TR) happens when the tricuspid valve, which controls blood flow between the heart's upper and lower right chambers, doesn't close correctly, causing blood to leak backward. After mitral valve surgery, TR can develop as a secondary issue due to long-standing left-sided valve failure, which increases pressure on the right side of the heart. This added pressure can lead to annular dilation, right ventricle enlargement, and leaflet tethering, all contributing to the tricuspid valve's malfunction. It was once thought that TR would improve on its own after mitral valve surgery, but it's now understood that direct repair of the tricuspid valve is often necessary.

How is tricuspid regurgitation (TR) that occurs after mitral valve surgery different from other types of tricuspid valve problems?

Tricuspid regurgitation (TR) after mitral valve surgery is typically 'secondary,' meaning it's not caused by a primary problem with the tricuspid valve leaflets themselves. Instead, it stems from other issues, primarily long-standing left-sided valve failure that increases pressure on the right side of the heart. This leads to annular dilation (widening of the valve ring), right ventricle enlargement, and leaflet tethering, which prevent the valve from closing properly. This is different from primary TR, where the valve itself has a structural problem.

What are the potential warning signs of tricuspid regurgitation (TR) that I should watch out for after undergoing mitral valve surgery?

Many patients don't experience symptoms of tricuspid regurgitation (TR) until the condition is advanced, so it's important to be vigilant. Potential warning signs include fatigue, swelling in the ankles and legs, abdominal bloating, shortness of breath (especially during exertion), and palpitations. Regular check-ups with your cardiologist are crucial for monitoring your heart health and detecting TR early, even if you don't notice any symptoms.

If I'm diagnosed with tricuspid regurgitation (TR) after mitral valve surgery, what treatment options are available to improve my heart health?

Effective treatments are available for tricuspid regurgitation (TR) following mitral valve surgery. The best course of action will depend on the severity of your condition and other individual factors. Options may include medical management with diuretics to reduce fluid buildup, but often surgical repair or replacement of the tricuspid valve is necessary to fully restore heart function. Guidelines now recognize that addressing TR, especially if it's severe or if the valve annulus is significantly dilated, is crucial for optimal outcomes.

Why did doctors initially believe tricuspid regurgitation would resolve on its own after mitral valve surgery, and what changed that understanding?

For years, doctors thought tricuspid regurgitation (TR) would improve spontaneously after mitral valve surgery addressed the primary mitral valve issue. The thinking was that correcting the left-sided heart problem would alleviate the pressure on the right side, allowing the tricuspid valve to function better. However, it became evident that in many cases, the tricuspid valve did not recover adequately, and its malfunction contributed significantly to ongoing heart failure symptoms. Recognizing this led to the current understanding that direct intervention on the tricuspid valve is often necessary to fully restore heart function and improve patient outcomes.