Background: We previously suggested preoperative determinants of surgical outcome in patients with isolated tricuspid regurgitation (TR). We here sought to find incremental value of immediate postoperative (IPO) echocardiographic finding in the prediction of long-term prognosis of patients with corrective TR surgery. Methods and Results: Total 70 patients (61 women, aged 57짹9 years; tricuspid valve repair for 8 and replacement for 62 patients) who underwent corrective surgery for isolated severe TR were enrolled. Twenty-seven patients (38%) were in New York Heart Association (NYHA) functional class (Fc) II, 37 (53%) in III, and 6 (9%) in IV. All patients underwent echocardiographic examination before surgery. After mean 37짹22 months of follow-up after surgery, 11 patients died, and 8 patients readmitted for clinical events. In univariate analysis, NYHA Fc, hemoglobin (Hb), platelet, creatinine, albumin, total cholesterol, preoperative right ventricular (RV) end diastolic area, preoperative RV end systolic area (ESA), preoperative RV fractional area change (FAC), IPO left ventricular end systolic dimension, IPO RV ESA, and IPO RV FAC were predictive of clinical events. In multivariate Cox models, IPO RV FAC (hazard ratio:-0.79, 95% confidence interval: 0.67 to 0.94; p=0.008) emerged as a significant predictor for long-term survival after TR surgery. By Cox proportional hazards model, the addition of IPO RV FAC markedly improved the prognostic usefulness of a model including Hb and preoperative RV ESA. Conclusions: IPO echocardiography-based RV FAC provides additional information on the prediction of a long-term outcome of patients who undergoing corrective surgery for TR on top of preoperative Hb and RV ESA.