Whole-Heart Tissue Engineering and Cardiac Patches: Challenges and Promises

Abstract

Despite all the advances in preventing, diagnosing, and treating cardiovascular disorders, they still account for a significant part of mortality and morbidity worldwide. The advent of tissue engineering and regenerative medicine has provided novel therapeutic approaches for the treatment of various diseases. Tissue engineering relies on three pillars: scaffolds, stem cells, and growth factors. Gene and cell therapy methods have been introduced as primary approaches to cardiac tissue engineering. Although the application of gene and cell therapy has resulted in improved regeneration of damaged cardiac tissue, further studies are needed to resolve their limitations, enhance their effectiveness, and translate them into the clinical setting. Scaffolds from synthetic, natural, or decellularized sources have provided desirable characteristics for the repair of cardiac tissue. Decellularized scaffolds are widely studied in heart regeneration, either as cell-free constructs or cell-seeded platforms. The application of human- or animal-derived decellularized heart patches has promoted the regeneration of heart tissue through in vivo and in vitro studies. Due to the complexity of cardiac tissue engineering, there is still a long way to go before cardiac patches or decellularized whole-heart scaffolds can be routinely used in clinical practice. This paper aims to review the decellularized whole-heart scaffolds and cardiac patches utilized in the regeneration of damaged cardiac tissue. Moreover, various decellularization methods related to these scaffolds will be discussed.

Advancements in tissue engineering for cardiovascular health: a biomedical engineering perspective

“…Moreover, the low complexity of current 3D-printed heart models refers to the simplified nature of the structures and functions that can be achieved with existing printing technologies (Jain et al, 2022). While some progress has been made in creating basic cardiac constructs, such as myocardial patches or simple tissue scaffolds, the ability to replicate the full complexity of the heart, including its multi-scale organization, heterogeneous cell populations, and dynamic mechanical properties, remains a significant challenge (Akbarzadeh et al, 2023). Addressing these limitations in 3D-bioprinting for heart tissue engineering requires advancements in printing technologies, biomaterials, and tissue engineering strategies.…”

Regeneration of the heart: from molecular mechanisms to clinical therapeutics

“…Therefore, understanding the molecular signaling induced by factors secreted by stem cells becomes more important for treatment of heart injury. Recent studies show that endoderm-derived islet1-expressing cells can differentiate into endothelial cells to function as hematopoietic stem and progenitor cells [ 130 ], which may serve as an alternative approach for stem cell transplant; in addition, human- or animal-derived decellularized heart patches have been used in vivo and in vitro studies to promote the regeneration of heart tissue [ 131 ]. However, due to the complexity of cardiac tissue engineering, significant hard work must be done before the approaches can be clinically used.…”

Cells and Materials for Cardiac Repair and Regeneration

“…The three methods all have advantages and shortcomings. For example, in the case of osmotic shock by incubation with hypotonic buffers, the subsequent treatment of the tissues with detergents (e.g., SDS) helps to remove lipids and DNA debris, but this could be detrimental for the maintenance of the glycosaminoglycans (GAGs), and even the stability of the collagen [98]. Furthermore, when using proteolytic enzymes, the ability of the cells to repopulate the cardiac cell-free scaffolds could be affected [99].…”