Similar to the pulmonary valve, it is unusual to primarily operate upon an adult's tricuspid valve.

The two most common reasons to operate on an adult's tricuspid valve are 1) so-called "functional" tricuspid regurgitation and 2) infection of the tricuspid valve.

When patients have high pressures in their lungs, usually from mitral valve disease, poor left ventricular function, or primary lung disease, the pressure on the right ventricle could be so great that the right ventricle enlarges rendering the tricuspid valve incompetent.

To reverse this condition, usually the surgeon only needs to place a prosthetic ring around the tricuspid valve so as to return it to it's normal size.  It almost never needs to be replaced for this condition.

Endocarditis (infection) of the tricuspid valve is rare.

Unfortunately, it usually occurs in patients who are intravenous drug users.  By using dirty needles, the blood returning to the heart is contaminated resulting in terrible infections of the tricuspid valve.

This is the one condition that usually requires replacing the tricuspid valve with a prosthetic valve, usually a porcine (pig) stented valve as shown below.