TRILUMINATE TR Severity (5-Grade) Calculator

TRILUMINATE TR Severity (5-Grade) Calculator: Explanation and Clinical Context This calculator classifies tricuspid regurgitation (TR) severity according to the 5-grade scheme used in the TRILUMINATE program (trace/mild, moderate, severe, massive, torrential). It integrates quantitative echocardiographic parameters — vena contracta (VC), effective regurgitant orifice area (EROA), regurgitant volume (RVol), and 3D vena contracta area (VCA) — using evidence-based thresholds. Thresholds: VC (mm): <3 mild, 3–6 moderate, 7–13 severe, 14–20 massive, ≥21 torrential.

EROA (mm²): <20 mild, 20–39 moderate, 40–59 severe, 60–79 massive, ≥80 torrential. RVol (mL/beat): <30 mild, 30–44 moderate, 45–59 severe, 60–74 massive, ≥75 torrential. VCA (cm²): <0.43 mild, 0.43–0.67 moderate, 0.68–0.88 severe, 0.89–1.26 massive, >1.26 torrential.

Clinical Significance: The 5-grade TR classification enhances discrimination in advanced disease and post-TEER follow-up. It was used in TRILUMINATE to guide analysis of procedural success, prognosis, and health-status improvement. Patients achieving ≤ moderate TR after edge-to-edge repair show greater KCCQ and 6-minute walk improvement compared with those with persistent severe TR.