Objectives: To investigate the safety and feasibility of three ports totally thoracoscopic surgery for tricuspid valve replacement in reoperative cardiac surgery.The clinical results was compared with right mini-thoracotomy. Methods: Between January 2018 and December 2020, 50 patients underwent tricuspid valve replacement with severe tricuspid regurgitation after left-sided valve surgery . Included patients were divided into two groups, totally thoracoscopic surgery (TTS Group, n=24) and right mini-thoracotomy (RMT Group, n=26). Operational data and clinical outcomes were compared between two groups. Results:Compared with RMT,Patients in TTS group had longer cardiopulmonary bypass time (113.4±46.5 vs 104.5±36.7min), but the difference was not significant. TTS lowered the total operation time( 210.3±56.7 vs 236.5±81.2 min;P=0.032),the volume of 24-hour chest drainage (248.5 ± 134.5 vs 316.5±181.2 ml ;P=0.021)and postoperative hospital stay time (9.5± 1.5 vs 11.2 ± 3.7 days; P = 0.044). No differences were found in postoprative comlications. one in-hospital death in RMT group. Conclusion: TTS is safe and feasible for tricuspid valve replacement in reoperative cardiac surgery. Compared with RMT, it has been associated with less trauma ,faster recovery.