Characterization of the mechanical properties of the coronary sinus for percutaneous transvenous mitral annuloplasty

The coronary sinus (CS) vessel serves as a conduit for the deployment of percutaneous transvenous mitral annuloplasty (PTMA) devices for the treatment of functional mitral regurgitation. Characterization of the mechanical response of the CS is an important step towards an understanding of tissue–device interaction in PTMA intervention. The purpose of this study was to investigate the mechanical properties of the porcine CS using the pressure–inflation test and constitutively model the wall behavior using a four fiber family strain energy function (SEF). The results showed that the CS exhibited an S-shaped pressure–radius response and could be dilated up to 88% at a pressure of 80 mm Hg. Excellent results from model fitting indicated that the four fiber family SEF could capture the experimental data well and could be used in future numerical simulations of tissue–device interaction. In addition, a histological study was performed to identify the micro-structure of the CS wall. We found a high content of striated myocardial fibers (SMFs) surrounding the CS wall, which was also mainly composed of SMFs, while the content of smooth muscle cells was very low. Elastin and collagen fibers were highly concentrated in the luminal and outer layers and sparsely distributed in the medial layer of the CS wall. These structural and mechanical properties of the CS should be taken into consideration in future PTMA device designs.