Prevalence and determinants of tricuspid regurgitation after repair of tetralogy of Fallot

•Determinants of tricuspid regurgitation (TR) in patients with repaired Tetralogy of Fallot (rTOF) remain incompletely understood.•Despite substantial RV volume overload, there was very little TR in patients following ToF repair (78% had none or mild TR).•RV volume, RA volume and tricuspid annular diameter correlated poorly with TR severity in rTOF.•Only rTOF was independently associated with higher TR fraction in a pooled cohort of patients with significant RV dilatation.•Our findings challenge commonly held notions regarding the pathophysiology of FTR with RV dilatation.