The ACC/AHA Guidelines give the following indications to surgically repair the tricuspid valve:

1. Repair of the tricuspid valve in severe tricuspid regurgitation when mitral valve surgery is planned (class I, level of evidence B).

2. Tricuspid valve replacement or annuloplasty ring is reasonable to severe primary tricuspid regurgitation when right heart failure symptoms are present (class IIa, level of evidence C).

3. Tricuspid valve replacement is reasonable for severe tricuspid regurgitation due to organic valve disease that is not amenable to annuloplasty ring (class IIa, level of evidence C).

4. Tricuspid annuloplasty ring may be considered for moderate tricuspid regurgitation in patients undergoing mitral valve surgery when there is pulmonary hypertension or tricuspid annular dilatation (class IIb, level of evidence C).