Progress in cardiovascular bioprinting

Abstract

Cardiovascular disease has been the leading cause of death globally for the past 15 years. Following a major cardiac disease episode, the ideal treatment would be the replacement of the damaged tissue, due to the limited regenerative capacity of cardiac tissues. However, we suffer from a chronic organ donor shortage which causes approximately 20 people to die each day waiting to receive an organ. Bioprinting of tissues and organs can potentially alleviate this burden by fabricating low cost tissue and organ replacements for cardiac patients. Clinical adoption of bioprinting in cardiovascular medicine is currently limited by the lack of systematic demonstration of its effectiveness, high costs, and the complexity of the workflow. Here, we give a concise review of progress in cardiovascular bioprinting and its components. We further discuss the challenges and future prospects of cardiovascular bioprinting in clinical applications.

CHIR99021 Promotes hiPSC‐Derived Cardiomyocyte Proliferation in Engineered 3D Microtissues

“…Additive manufacturing such as 3D bioprinting appears to be a promising approach to fabricate a complex vascularized cardiac tissue. [ 18 ] However, the cell density of bioinks is limited due to shear stress‐induced cell death and altered mechanical properties of the ink. [ 19 ] Consequently, engineered cardiac tissues are often characterized by electrically isolated patches of cardiomyocytes resulting in heterogeneous beating activity.…”

Construction of tissue-customized hydrogels from cross-linkable materials for effective tissue regeneration

“…224,225 Therefore, 3D printing has been used to manufacture different materials of different shapes with multiple functions for heart regeneration. 226 To construct a functional artificial heart, natural materials have been applied to form the ECM, native structures, and blood vessels, whereas synthetic materials have been applied together to supply tailored functions and properties such as electrical conduction and cellular polarization. 226,227 When the human heart is under systole, the stiffness of the myocardium reaches as high as 500 kPa.…”

“…226 To construct a functional artificial heart, natural materials have been applied to form the ECM, native structures, and blood vessels, whereas synthetic materials have been applied together to supply tailored functions and properties such as electrical conduction and cellular polarization. 226,227 When the human heart is under systole, the stiffness of the myocardium reaches as high as 500 kPa. But, when it is under diastole, the stiffness of the myocardium is decreased to 20 kPa.…”

Advances and challenges in bioprinting of biological tissues and organs

“…11 The FRESH bioprinting enabled the fabrication of biomimetic heart constructs, including various levels of hierarchy ranging from capillaries to the whole heart 11 ; however, the bioprinting of a functional heart is yet to be achieved. 11,29 To achieve fully functional tissue constructs, there is a need to overcome substantial challenges, such as printing high cell-density constructs, including billions of tissuespecific cells for biological activity and tissue regeneration after implantation. Furthermore, there is a need to evaluate the functionality of printed organs using accurate in vitro assays closely mimicking physiological conditions and develop advanced bioreactor systems for maintaining the perfusion throughout the human-scale constructs.…”

“…In a breakthrough discovery, researchers bioprinted the human heart using a novel class of 3D bioprinters based on freeform reversible embedding of suspended hydrogels (FRESH) bioprinting, which consisted of a bath of microparticle slurry in which the bioinks were extruded to provide external support for constructing large‐scale and high‐resolution constructs (Figure 1E). 11 The FRESH bioprinting enabled the fabrication of biomimetic heart constructs, including various levels of hierarchy ranging from capillaries to the whole heart 11 ; however, the bioprinting of a functional heart is yet to be achieved 11,29 …”