It is reported that 65–85% of the population present with trivial to moderate TR which remain asymptomatic until it is discovered in an echocardiogram for preoperative cardiac evaluation or routine cardiovascular checkup (3). Moderate to severe TR occurs in patients with right- and left-sided congenital and acquired diseases and may be associated to bi-ventricular failure, increased risk for associated morbidity such as pulmonary arterial hypertension (PAH), hepato-renal syndrome and mortality (2,3).