Emergence of Three Dimensional Printed Cardiac Tissue: Opportunities and Challenges in Cardiovascular Diseases

Abstract

Three-dimensional (3D) printing, also known as additive manufacturing, was developed originally for engineering applications. Since its early advancements, there has been a relentless development in enthusiasm for this innovation in biomedical research. It allows for the fabrication of structures with both complex geometries and heterogeneous material properties. Tissue engineering using 3D bio-printers can overcome the limitations of traditional tissue engineering methods. It can match the complexity and cellular microenvironment of human organs and tissues, which drives much of the interest in this technique. However, most of the preliminary evaluations of 3Dprinted tissues and organ engineering, including cardiac tissue, relies extensively on the lessons learned from traditional tissue engineering. In many early examples, the final printed structures were found to be no better than tissues developed using traditional tissue engineering methods. This highlights the fact that 3D bio-printing of human tissue is still very much in its infancy and more work needs to be done to realise its full potential. This can be achieved through interdisciplinary collaboration between engineers, biomaterial scientists and molecular cell biologists. This review highlights current advancements and future prospects for 3D bio-printing in engineering ex vivo cardiac tissue and associated vasculature, such as coronary arteries. In this context, the role of biomaterials for hydrogel matrices and choice of cells are discussed. 3D bio-printing has the potential to advance current research significantly and support the development of novel therapeutics which can improve the therapeutic outcomes of patients suffering fatal cardiovascular pathologies.

Bioengineering approaches to mature induced pluripotent stem cell-derived atrial cardiomyocytes to model atrial fibrillation

“…Despite improving CM maturation and enabling electromechanical stimulation, hydrogel-based 3D cardiac platforms pose difficulty in scaling up the study throughput due to complex and expensive fabrication/operation of support structures and mechanical tools. 112–114 On the other hand, 3D printing technology (e.g. microextrusion method, ink-jet method, and stereolithography) has the potential to overcome this barrier with large/macro scale tissue generation of hydrogel-based 3D cardiac structures.…”

When Stiffness Matters: Mechanosensing in Heart Development and Disease

“…However, as mentioned previously, the canonical 2D culture and differentiation of these cells still has major limitations, most notably their immature phenotype, which lacks to fully represent developed tissue. The development of new biomaterials (Reis et al, 2016;Wissing et al, 2017;Kuraitis et al, 2019) and the emerging of new technologies such as tissue printing (Charbe et al, 2019;Tomov et al, 2019), organ on a chip (Marsano et al, 2016;Ugolini et al, 2018;Wan et al, 2018), and different types of bioreactors that allow mechanical, perfusion, or electrical stimulation (Freed et al, 2006;Lei and Ferdous, 2016;Paez-Mayorga et al, 2019) allow us to generate cardiac tissue that more closely recapitulate the (patho)physiological features of the developed myocardium. Moreover, these models represent an optimal tool not only to test and validate new drugs or to re-create tissue substitute for regenerative medicine application but also to allow a better understanding of the molecular mechanisms behind disease development and progression.…”

3D printing in hand surgery

“…For example, 3D printing can be used to make bone models that mimic the characteristics of human bone and can be used during biomechanical studies [24], especially comparisons of different bone fixation methods [25]. Among the future applications are regenerative medicine with bioprinting of stem cells on implants and bone matrix for osteotomies [26], like the organ regeneration described not long ago [27,28]. To our knowledge, no studies with 3D objects have been done in the context of theoretical learning for hand surgery.…”