Budharaju Harshavardhan, Subramanian Anuradha, Sethuraman Swaminathan
Tissue Engineering & Additive Manufacturing (TEAM) Lab, Centre for Nanotechnology & Advanced Biomaterials, ACBDE Innovation Centre, School of Chemical & Biotechnology, SASTRA Deemed to be University, Thanjavur 613 401, India.
Biomater Sci. 2021 Mar 21;9(6):1974-1994. doi: 10.1039/d0bm01428a. Epub 2021 Feb 10.
Cardiovascular diseases (CVDs) are the leading causes of mortality globally that demand the application of tissue engineering strategies to repair damaged tissues. Conventional tissue engineering approaches such as particulate leaching, hydrogels, gas foaming, solvent casting and electrospinning based strategies aim to develop extracellular matrix analogues to promote the regeneration of functional cardiac tissues. However, poor cell seeding efficiency with the non-uniform distribution of cells across thicker scaffolds (>5 mm) limits the clinical potential. The advent of 3D bioprinting offers layer-by-layer cellular integration and facilitates the recapitulation of cellular heterogeneity and intricate hierarchical structural organization. Although the success of 3D bioprinting of cardiac specific tissues has been demonstrated in varying degrees, maintaining unique architecture, cellular heterogeneity and cardiac functions demands the search for cardiac-specific bioinks. Hence, this review outlines the various bioinks explored in the printing of cardiac tissues and the essential properties such as rheological and electromechanical characteristics necessary for the functional restoration. This review further describes the application of 3D bioprinting for the fabrication of several cardiac tissues such as heart valves, coronary arteries, cardiac patches and whole heart. Finally, this review summarizes the existing limitations, unmet technical challenges and potential future focus on the expansion of bioprinting technique to cardiovascular medicine.
心血管疾病（CVDs）是全球主要的死亡原因，需要应用组织工程策略来修复受损组织。传统的组织工程方法，如颗粒沥滤、水凝胶、气体发泡、溶剂浇铸和基于静电纺丝的策略，旨在开发细胞外基质类似物，以促进功能性心脏组织的再生。然而，在较厚的支架（>5毫米）上细胞接种效率低且细胞分布不均匀，限制了其临床应用潜力。3D生物打印技术的出现实现了细胞的逐层整合，并有助于重现细胞异质性和复杂的层次结构组织。尽管不同程度地证明了心脏特异性组织3D生物打印的成功，但要维持独特的结构、细胞异质性和心脏功能，仍需要寻找心脏特异性生物墨水。因此，本综述概述了在心脏组织打印中探索的各种生物墨水，以及功能恢复所需的流变学和机电特性等基本属性。本综述进一步描述了3D生物打印在制造多种心脏组织（如心脏瓣膜、冠状动脉、心脏补片和全心脏）方面的应用。最后，本综述总结了现有局限性、未解决的技术挑战以及未来将生物打印技术扩展到心血管医学领域的潜在重点。
