Conclusions
Prophylactic tricuspid TA should be encouraged among surgeons even earlier than guidelines recommend, and decision-making for the treatment of low-graded TR at the time of left-sided valve surgery should consider not only annular size, but also tethering severity and RV remodeling. In these cases, the surgical approach should not be limited to TA, but surgeons should consider alternative techniques or prosthesis implantation.
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