Abstract Background: Functional tricuspid regurgitation (FTR) is the most common form of tricuspid valve (TV) disease. FTR is the result of changes in the tricuspid annular geometry caused by dilatation of the right ventricle in the absence of structural valve abnormalities F11i; is caused by left-sided heart disease and subsequent pulmonary hypertension. Historically, FTR was believed to be benign and to resolve after the left-sided heart disease was corrected. However, recent research shows that FTR is an ongoing process, which can even worsen if left untreatedand that the presence of TV regurgitation is associated with impaired long-term survival. Aim of Study: To assess postoperative clinical and echocar-diographic outcomes, especially operative mortality, functional recovery, and change in TR after tricuspid valve surgery for FTR during left-sided heart valve surgeryDetermine periopera-tive predictors of unfavorable outcomes After Tv Surgery. Patients and Methods: This retrospective study reviewed medical records and follow-up cards of adult patients who un-derwent open heart surgery for left-sided heart valve replace-ment, between January 2018 and December 2022, at Ain Shams University and Minia University Hospitals. The study included patients who underwent left-sided (mitral and/or aortic) heart valve surgery and tricuspid valve surgery with functional tri-cuspid regurge (FTR). Results: PH, is likely because of TVR/TVr being more of-ten performed as a concomitant procedure to either mitral or aortic valve surgery. The majority of patients in our analysis underwent TVR/TVr in conjunction with mitral valve or aortic valve surgeries (56%). In our study most of patient 98% due torehumatic heart disease, also most of patient 98% were un-derwent mitral valve replacement. Conclusion: A concomitant TV repair strategy during left-sided valve surgery should be treated to improve patient outcomes by giving benefit of doubt to prevent regurgitation progression, RV dysfunction and is associated with a reduction in cardiac-related mortality and improved echocardiographic TR outcomes at follow-up.