Types of Surgery : Tricuspid valvotomy is done as an open procedure at the end of surgery on mitral and/or aortic valve. It can be done on an arrested heart or on a beating heart on cardio pulmonary bypass with the vena cavae snared. The commissures between septal and anterior and septal and posterior are divided one mm short of the annulus. The commissures between the anterior and posterior leaflets are never divided, as it will produce significant tricuspid regurgitation. Many surgeons add a De Vega annuloplasty along with tricuspid valvotomy. If the valve cannot be repaired, tricuspid valve is replaced with a suitable bioprosthetic valve. A metallic prosthesis in tricuspid position is prohibitively thrombogenic and is not advisable.
A bioprosthesis in the tricuspid position lasts longer than in the mitral.