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Management of tricuspid regurgitation for more than 25 years to aware of TR complicated in large number of RHD TR is progressive disease after MVR Tricuspid annuloplasty must be done when annulus diameter is 21mm/m2 Make every effort to avoid doing TV replacement Management of calcified annulus prevalence more than 1/3 posteriomedial annulus involved treatment completely removing the calcification cautions avoid injuring ventricular myocardium and coronary vessels Management of calcified annulus Management of calcified annulus THANKS ! Changhai Hospit