If you have severe tricuspid valve regurgitation, doctors may recommend repair or replacement surgery.

The tricuspid valve is one of four valves in your heart’s four chambers. It’s on the right side of your heart between the upper and lower chambers. The valve has three leaflets that allow blood to flow through it.

Having tricuspid regurgitation means your tricuspid valve allows blood to flow backward through the valve.

If severe, doctors may recommend surgery to repair or replace the valve. Untreated, severe tricuspid valve regurgitation can lead to a backup of blood in the right side of the heart, known as right sided heart failure. This can lead to abdominal swelling, enlarged liver, weight gain, and fatigue.

Keep reading to learn how doctors treat tricuspid valve regurgitation with surgery, what the options are, and what recovery looks like.

If tricuspid valve regurgitation requires treatment, doctors typically treat it with medication like diuretics to help manage symptoms from fluid buildup.

However, some people with tricuspid valve regurgitation may benefit from surgery. Heart valve surgery carries risks and may not be successful for all people with tricuspid valve regurgitation. Doctors consider the possible risks and benefits when considering whether to recommend surgery.

Doctors may recommend surgery for people with tricuspid valve regurgitation who:

  • are undergoing surgery on the left side of the heart
  • have severe primary tricuspid valve regurgitation, which refers to tricuspid valve regurgitation that results from:
    • infective endocarditis (inflammation of the inner lining of the heart)
    • leaflet perforation
    • entrapment after device placement
    • congenital abnormalities
  • have severe secondary tricuspid valve regurgitation, which refers to tricuspid valve regurgitation caused by another heart condition, that does not respond to medical therapy

Tricuspid valve repair is typically performed as an open-heart surgery. However, newer techniques allow for minimally invasive catheter repair for some people.

The exact way the surgeon repairs the valve can depend on the specific damage to it. For instance, they may:

  • reshape the valve
  • reconnect a damaged valve leaflet
  • strengthen a leaf by adding a ring to reinforce it
  • repair the tissue that connects the valve to the heart muscle

The American Heart Association notes that it’s generally best to repair a valve over replacing it, if possible. Repairing the valve preserves the person’s heart tissue.

Tricuspid valve replacement is also usually performed as an open-heart surgery, though transcatheter replacement is an option for some people.

It involves replacing a valve that has been damaged beyond repair. A surgeon may replace it with:

  • a valve made from tissue from a human or animal donor
  • a mechanical valve made of synthetic materials

Depending on your circumstances, you may be able to have a minimally invasive form of tricuspid valve surgery. These surgeries typically involve smaller incisions. Whether a doctor may recommend this type of surgery can depend on the other procedure you’re undergoing and your overall health.

These options may include:

  • surgery performed through a catheter (transcatheter valve repair or replacement)
  • robot-assisted surgery
  • a surgical approach that goes through your ribs called a right thoracotomy approach

Transcatheter tricuspid valve repair and replacement may be a lower risk option for some people with tricuspid valve regurgitation.

Minimally invasive procedures can reduce the risk of complications and have a shorter recovery.

Any heart surgery, including tricuspid valve surgery, has risks. The possible complications that happen during or after tricuspid valve surgery or any heart surgery may include:

  • issues with your heart, including arrhythmias and heart failure
  • bleeding
  • stroke
  • infection
  • issues with your lungs
  • valve malfunction
  • kidney failure, especially if you have kidney issues

Your surgeon typically reviews the potential risks with you ahead of your specific procedure.

These decisions are made by a team of cardiologists and surgeons who evaluate your health and weigh the risks and benefits of repair or replacement surgery.

If you’re concerned about the possible risks of surgery, it’s best to talk with your surgical team. They can explain the possible benefits and risks of surgery for your specific circumstances.

After heart surgery, you will likely stay in the hospital for a few days as you recover. The amount of time can depend on the type of surgery you had as well as your risk factors for complications.

A doctor may also prescribe medications to reduce your risk of blood clots and infection.

The surgery team will likely order imaging and other tests to ensure that the repaired or replacement valve is working properly before you continue your recovery at home.

A member of your care team will go over instructions for your continued recovery at home.

The recovery period typically lasts 4 to 8 weeks but can depend on your specific procedure and overall health. During your recovery, you will gradually return to your typical activity level. A doctor usually provides restrictions that they adjust as you progress in your recovery.

At first, you may not be able to:

  • bend down
  • lift anything
  • raise your arms over your head
  • drive

Tricuspid valve regurgitation surgery involves repairing or replacing the faulty valve.

Doctors typically recommend this surgery in certain cases when the valve disease is severe and causing symptoms, or if you’re already having heart surgery for another issue.

However, newer procedures like a transcatheter valve repair or replacement may reduce the risks associated with open-heart surgery.