Echocardiographic evaluation
In all patients, ejection fraction, left ventricular diameters were measured by echocardiography, according to the recommendations of the American Association of Echocardiography6. Tricuspid annulus, TV coaptation depth (CD) and tenting area were collected in apical 4-chamber view. TR severity was graded as mild, moderate, severe6. Recurrence of TR was defined as the presence of TR graded moderate-or-more. TV remodeling was defined according to at least one cutoff (CD≥6.5 mm, tenting area ≥0.85 cm2 and tricuspid annulus≥35 mm)5.RV dilatation was defined as a basal end-diastolic diameter >42 mm and/or mid-level diameter >35 mm7,8. RV dysfunction was defined as TAPSE <16 mm and/or TDI-S’ velocity <10 cm/sec7,8. Right ventricular remodeling was defined as RV dilatation and/or dysfunction. A systolic pulmonary pressure (sPAP)>55mmHg was considered as severe pulmonary hypertension7,8. Failure of MV surgery at follow-up was defined MV area ≤1.5 cm² and/or moderate-or-more regurgitation.