A 30-year old man underwent a head-on motor accident and was admitted to hospital, where he was successfully treated for several injuries. He was discharged home with slight tricuspid regurgitation, without signs of hemodynamic decompensation, and required no further treatment. Five years later he was admitted to the National Institute of Cardiology due to overt right ventricular failure secondary to tricuspid valve regurgitation. After several unsuccessful attempts at papillary muscle and chordal repair, a 33-mm SJM Biocor valve was implanted. This case history underlines the value of echocardiography, even after blunt chest trauma without cardiac symptoms. A good functional result can be achieved years after onset of traumatic valve insufficiency, but early diagnosis and surgical treatment increases the feasibility of tricuspid valve repair rather than replacement, and also prevents progressive deterioration of right ventricular function.