Padalino MA, et al. - The existence of a link between the transventricular (TV) or transatrial (TA) approach and right ventricular (RV) function was examined in this study along with an analysis of the role of residual pulmonary regurgitation (PR) on the long-term outcomes. Findings did not disclose any prominent variation in RV volumes and function between the TA and TV. TA approach appeared to be protective against pulmonary valve (PV) replacement in the long-term. Residual pulmonary regurgitation served as a major cause of late RV dysfunction and dilation when PV was not preserved at repair. It displayed a correlation with a higher rate of late adverse events.