Tricuspid Valve Surgery and Evolving Strategies
RITS carried a high risk and the decision to perform an operation was considerably cautious. The indications were previously described [11]. From 1998 to 2012, RITS were all performed through median sternotomy, and beating-heart or aortic cross-clamping were applied (Figure 1). The first case of e-RITS was performed late in 2013 and updated strategies of TVr with leaflets augmentation also started in 2015, and we preferred early RITS before New York Heart Association (NYHA) heart function class reached IV when patients had apparently impaired right heart function.