الفهرس 
Introduction
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Abstract
The aortic and mitral valves are involved in rheumatic disease showing gross changes after an acute or chronic inflammatory reaction. The diseases of the tricuspid valve frequently present in the form of regurgitation, which is functional secondary to left sided valvular or myocardial disease with subsequent pulmonary congestion, right ventricular hypertrophy and dilatation with subsequent annular enlargement.
Functional tricuspid regurgitations should be surgically treated and severe lesions are obvious candidates for repair.
Left side heart rheumatic disease should be treated early before development of right ventricular dilatation and subsequent tricuspid regurge.
We recommend ring annuloplasty for severe functional tricuspid repair as treatment of choice because it has lesser rate of recurrence, prevent further annular dilatation and better impact on right ventricular remodeling.
We do not recommend using of Devega technique in severe functional tricuspid regurge as it is not guarding against further annular dilatation and right side heart failure which carry risk of reoperation to control symptoms of right side failure. Incompetence resulting from the sutures cutting through or breaking which gives a guitar string appearance at reoperation.
Long term follow up is essential to evaluate the effect of ring repair regarding recurrence and effect on right ventricular diameter and function.