Functional or secondary tricuspid regurgitation (STR) is the most frequent etiology of tricuspid valve pathology in Egypt. Surgical tricuspid repair has been avoided for years, because of the misconception that tricuspid regurgitation should disappear once the primary left-sided problem is treated; this results in a large number of untreated patients with STR. Over the past few years, many investigators have reported evidence in favor of a more aggressive surgical approach to STR. Consequently, interest has been growing in the physiopathology and treatment of STR. The purpose of this review is to explore the anatomical basis, pathophysiology, therapeutic approach, and future perspectives with regard to the management of STR. In this study I wanted to determine if there is near-term postoperative progression of non-corrected moderate functional TR in patients who underwent mitral valve replacement for rheumatic mitral disease and if RV size and function were affected. Methods and Results: I compared two groups of patients prospectively. In the first group (group A, n 20 ), tricuspid valve annuloplasty (TVA) in the form of De vega repair had been performed in conjunction with mitral valve replacement (MVR). The second group (group B, n 20 ) underwent MVR without TVA. Group A revealed a significant decrease in TR and right ventricle diameter. In group B, (6) patients (32%) showed a significant progression of the non-corrected TR together with dilatation and decreased ejection fraction of the right ventricle. Conclusion: Tricuspid annuloplasty performed concurrently with MVR can prevent subsequent progression of tricuspid regurgitation along with right ventricular dilatation and systolic dysfunction in the near-term postoperative period.