What is the clinical evidence from this study?

Study design: RCT. Population: severe rheumatic mitral stenosis and moderate functional tricuspid regurgitation (n=50). Intervention: Mitral valve replacement with tricuspid valve repair (DeVega annuloplasty) vs. Mitral valve replacement alone. Primary outcome: No tricuspid regurgitation at 12 months (p=<0.001).

April 8, 2026Al-Azhar Assiut Medical JournalOpen Access

Concomitant tricuspid repair during MVR reduces TR progression, leaving ~92% TR-free versus MVR alone.

Q: What are the key findings of this study?

Concomitant tricuspid valve repair during mitral valve replacement significantly reduced TR progression, with 92% of patients showing no TR at 12 months versus 0% with MVR alone (P<0.001).

Q: What question did this study set out to answer?

This research investigates the effects of tricuspid valve repair during mitral valve replacement on the outcomes of moderate tricuspid regurgitation.

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Why the study?

The management of moderate functional TR during MVR remains debated, as it is often overlooked despite its potential to progress and worsen outcomes.

Does concomitant tricuspid valve repair during mitral valve replacement reduce tricuspid regurgitation progression and improve right ventricular function in patients with severe rheumatic mitral stenosis and moderate functional tricuspid regurgitation?

Population

50 patients with severe rheumatic mitral stenosis and moderate functional TR

Comparison

MVR with concomitant TVR vs MVR alone

Design

Prospective randomized trial

Follow-up

12 months

Key result

Concomitant tricuspid valve repair during mitral valve replacement significantly reduced TR progression, with 92% of patients showing no TR at 12 months versus 0% with MVR alone (P<0.001).

Authors

AKAhmed D. Abdelraheem Khalifa AAAbdelkareem Abdelkareem JAJohn S.Y. Awad

Discussion

Member takes

Overview

Warrants concomitant TV repair for moderate functional TR during MVR; confirms benefit in rheumatic mitral stenosis.**[[1]](https://journals.lww.com/aamj/fulltext/2026/01000/concomitant_tricuspid_valve_repair_in_rheumatic.17.aspx)[[2]](https://journals.lww.com/aamj/fulltext/2025/10000/surgical_outcomes_of_patients_complaining_of.12.

Key Points

This research investigates the effects of tricuspid valve repair during mitral valve replacement on the outcomes of moderate tricuspid regurgitation.
Prospective randomization of 50 patients with severe rheumatic mitral stenosis and moderate TR into two groups.
Group A underwent mitral valve replacement with tricuspid valve repair, while Group B underwent mitral valve replacement alone.
Clinical and echocardiographic evaluations conducted preoperatively and at 3, 6, and 12 months post-surgery.
Group A showed significant reduction in TR progression with 92% of patients showing no TR at 12 months.
Right ventricular function improved in the repair group, with increased tricuspid annular plane systolic excursion.
Pulmonary artery systolic pressure significantly decreased in the patients who had concomitant tricuspid valve repair.

Study Design

Type

RCT (n=50)

Randomization

randomized

Structured PICO

Population

50 patients with severe rheumatic mitral stenosis and moderate functional tricuspid regurgitation

Intervention

Mitral valve replacement (MVR) with concomitant tricuspid valve repair (TVR, DeVega annuloplasty)

Comparator

Mitral valve replacement (MVR) alone

Outcome

Progression of tricuspid regurgitation and clinical outcomes at 12 monthssurrogate

Main Result

Absolute Event Rate: 92% vs 0%

p-value: p=<0.001

Concomitant tricuspid valve repair during mitral valve replacement for moderate functional tricuspid regurgitation significantly reduces disease progression and improves right ventricular hemodynamics at 1 year.

Cite This Study

Khalifa et al. (2026) conducted an RCT in severe rheumatic mitral stenosis and moderate functional tricuspid regurgitation (n=50). Mitral valve replacement with tricuspid valve repair (DeVega annuloplasty) vs. Mitral valve replacement alone was evaluated on No tricuspid regurgitation at 12 months (p=<0.001). Concomitant tricuspid valve repair during mitral valve replacement significantly reduced TR progression, with 92% of patients showing no TR at 12 months versus 0% with MVR alone (P<0.001).

synapsesocial.com/papers/69d5f03374eaea4b11a79a68 https://doi.org/10.4103/azmj.azmj_81_25

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April 8, 2026Al-Azhar Assiut Medical JournalOpen Access

Concomitant tricuspid repair during MVR reduces TR progression, leaving ~92% TR-free versus MVR alone.

View Full Paper

Ask AI

Bookmark

Why the study?

The management of moderate functional TR during MVR remains debated, as it is often overlooked despite its potential to progress and worsen outcomes.

Population

50 patients with severe rheumatic mitral stenosis and moderate functional TR

Comparison

MVR with concomitant TVR vs MVR alone

Design

Prospective randomized trial

Follow-up

12 months

Key result

Concomitant tricuspid valve repair during mitral valve replacement significantly reduced TR progression, with 92% of patients showing no TR at 12 months versus 0% with MVR alone (P<0.001).

Authors

AKAhmed D. Abdelraheem Khalifa AAAbdelkareem Abdelkareem JAJohn S.Y. Awad

Discussion

Member takes

Overview

Key Points

This research investigates the effects of tricuspid valve repair during mitral valve replacement on the outcomes of moderate tricuspid regurgitation.
Prospective randomization of 50 patients with severe rheumatic mitral stenosis and moderate TR into two groups.
Group A underwent mitral valve replacement with tricuspid valve repair, while Group B underwent mitral valve replacement alone.
Clinical and echocardiographic evaluations conducted preoperatively and at 3, 6, and 12 months post-surgery.
Group A showed significant reduction in TR progression with 92% of patients showing no TR at 12 months.
Right ventricular function improved in the repair group, with increased tricuspid annular plane systolic excursion.
Pulmonary artery systolic pressure significantly decreased in the patients who had concomitant tricuspid valve repair.

Study Design

Type

RCT (n=50)

Randomization

randomized

Structured PICO

Population

50 patients with severe rheumatic mitral stenosis and moderate functional tricuspid regurgitation

Intervention

Mitral valve replacement (MVR) with concomitant tricuspid valve repair (TVR, DeVega annuloplasty)

Comparator

Mitral valve replacement (MVR) alone

Outcome

Progression of tricuspid regurgitation and clinical outcomes at 12 monthssurrogate

Main Result

Absolute Event Rate: 92% vs 0%

p-value: p=<0.001

Cite This Study

synapsesocial.com/papers/69d5f03374eaea4b11a79a68 https://doi.org/10.4103/azmj.azmj_81_25

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

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