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TRILUMINATE TR Severity (5-Grade) Calculator

  • Vena contracta width (VC) (mm)
  • Effective regurgitant orifice area (EROA) (mm2) (optional but recommended)
  • Regurgitant volume (RVol) (mL/beat) (optional)
  • Vena contracta area (VCA) (cm2) (optional; 3D/planimetry)
  • 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.

    References:
    Sorajja P, et al. N Engl J Med. 2023;388:1833–1844.
    ClinicalTrials.gov. NCT03904147 (TRILUMINATE Pivotal).
    Ambrosino M, et al. J Am Heart Assoc. 2024;13:e032999.
    Go YY, et al. Front Cardiovasc Med. 2018;5:164.
    Miura M, et al. JACC Cardiovasc Interv. 2020;13:2244–2255.
    Arnold SV, et al. J Am Coll Cardiol. 2024;83:105–117.
    Benzoni G, et al. 2025 (VCA thresholds for STR severity).
    Tang GHL, et al. TRILUMINATE Randomized Cohort, 2025.