Study Population
We retrospectively reviewed patients undergoing tricuspid valve surgery according to surgery ICD code (35.14; 35.28) from 1999 to 2019 in Guangdong Provincial Cardiovascular Institute. More than 15 000 patients underwent tricuspid valve surgery in this period. The selection criteria were 1) previous LSVS with or without concomitant tricuspid valvuloplasty, and 2) RITS by an endoscopic approach or median sternotomy, tricuspid valve replacement (TVR) or tricuspid valve repair (TVr). The exclusion criteria were 1) TR due to endocarditis, congenital disease, trauma, or carcinoma, and 2) repeat TVR due to prostheses failure. A total of 173 cases were included and were divided into two subgroups: RITS by median sternotomy (m-RITS) and by totally endoscopic approach (e-RITS).