Tissue engineering approaches for the development of a contractile cardiac patch.

Cardiac tissue engineering is an emerging field that aims to enhance cardiac function in patients with heart disease or congenital malformations, by providing suitable implantable replacement tissues. Various groups have developed methods of cultivating contractile 3D cardiac grafts that display functional and morphological properties of native myocardium, integrate into native tissue and provide improvement in cardiac function upon grafting onto infarcted hearts. However, several critical goals must be met before this therapy can be implemented clinically: the identification and harvesting of an appropriate human cell source, the cultivation of relatively thick ( approximately 1 cm) constructs, and the in vitro and/or in vivo vascularization of these constructs. Advances in enabling bioreactor technologies and the identification of key parameters governing the differentiation of cardiac cells will be crucial to advancement in this field.