Introduction
Several studies have focused on the anatomy and pathophysiology of
secondary tricuspid regurgitation (TR) associated with left heart
disease or atrial fibrillation (1,2). Patients with significant TR,
especially that in the severe range, have a poor prognosis (3,4).
Surgical treatment can produce excellent results in patients with severe
TR that medical treatment is unable to control (4,5). However, patients
requiring reoperation because of significant residual or recurrent TR
have a poor prognosis with high mortality (6). Therefore, it is very
important to address TR during the operation and analyze the risk
factors for residual TR after tricuspid valve (TV) repair (7-9).
Sakon et al. (10) recently demonstrated that the number of posterior
leaflets was two or more in a half of the patients analyzed in their
study. However, no studies have shown that morphological diversity of
the TV affects the outcomes and surgical techniques of TV repair. The
present study was performed to investigate the effect of morphological
diversity of the TV on the difficulty of controlling TR during TV
repair.