Juan A. Crestanello, M.D., is a cardiovascular surgeon and department chair of Cardiovascular Surgery at Mayo Clinic in Rochester, Minnesota. Dr. Crestanello, who specializes in surgery for valvular heart disease, discusses concomitant tricuspid repair in patients with degenerative mitral regurgitation. Welcome to the cardiovascular surgery series where I review the latest research in cardiovascular surgery. I am dr one person. Hello I am a cardiac surgeon at the mayo clinic in Rochester Minnesota. Today I will review the multi center trial by the cardiothoracic surgery trials network. The title of the trial is concomitant tricastin repair in patients with degenerative mitral regurgitation. In this trial Gammy and Associate reported that the addition of Tricastin Daniela plastic to patients with moderate or less tricastin resuscitation during my trial surgery reduced the rate of progression to severe tr from 6.1% in the microsurgery along group 2.6%. In the combined group. These results should be interpreted in the context of the two populations of patients including the trial one group were the patients with hospital annual dilatation and less than moderate track a spectral visitation. The second group were the patients with moderate tricastin resuscitation, Patients with like a spit annular dilatation and less than moderate hospital visitation. Baseline constituted more than 60% of the trial population in this group tr progression was not observed in any of them with or without a hospital. You know blasting progression of TR was only seen in the patients with moderate tricastin regurgitation at baseline. While tricastin placed e had no effect on tR progression in the groups with in the group with the hospital and rehabilitation and less than moderate tr it effectively reduced tricastin regurgitation progression in those with moderate trikus period visitation. We conclude that the contribution of tri capital neural plasticity in reducing tricastin negotiation progression. What was diminished given the differences in population size and in the natural history of untreated TR between the two groups. Consequently, pending further follow up, we believe that the capital neural plasticity is not indicated for patients with and rehabilitation and less than moderate TR, particularly in view of the increased need for permanent pacemaker. Among those patients, thank you for listening to the Mayo Clinic cardiovascular surgery series.