Triluminate Pivotal Trial is a randomized trial in which patients with severe tricuspid regurgitation at intermediate or greater risk for mortality with tricuspid valve surgery are randomized in 1:1 fashion to TriClip device treatment (Abbott Structural, Santa Clara, CA) or Medical Therapy. 700 participants will be enrolled in the study. Estimated primary completion date is August 2022. The primary outcome is a hierarchical composite of number of participants with Tricuspid valve surgery, rate of heart failure hospitalizations and assessment of quality of life at 12 months.