With an adult atrial septal defect, there was often regurgitation of the mitral and tricuspid valve due to volume overload in a long term period. Especially concerning tricuspid regurgitation, what can be done surgically has not yet been decided. For severe tricuspid regurgitation, some cases where tricuspid valve annuloplasty were performed have had exacerbation of tricuspid regurgitation. We experienced a case where tricuspid valve supraanular implantation without excision of native tricuspid valve (TVSI) was performed for severe tricuspid regurgitation associated with atrial septal defect, and improved. A 53-year-old female complained of dyspnea on exertion. An atrial septal defect was revealed being 4 cm in size, complicated with severe tricuspid regurgitation (IV), and 62 mmHg difference of pressure from the right atrium to right ventricle shown by a ultrasonography. Pulmonary artery pressure was 66/16 mmHg by cardiac catheter. Patch closure for ASD and TVSI for TR was performed on her, and amelioration of cardiac function was recognized.