Cardiac tissue regeneration in bioreactors

Motivation for cardiac tissue regeneration in vitro Myocardial infarction (MI) leads to the death of cardiomyocytes, and the infarct area becomes replaced by a fibroblastic scar tissue that has no contractile function. This reduces the pumping ability of the heart and the cardiac output. In addition, the scar tissue thins due to the lack of vasculature to provide oxygen and nutrients to the infarct site, thus leading to high wall stress and cardiac dilatation, which may ultimately lead to heart failure. The adult heart has a limited regenerative capacity. The shortage of donor organs further suggests a need to develop new treatment strategies for cardiovascular diseases. Cardiac tissue regeneration can be achieved through several strategies, including (1) gene therapy, (2) cell transplantation, and (3) implantation or injection of biomaterials or engineered cardiac tissues. The goal of these cardiac tissue regeneration strategies is to repair the damaged myocardium through supporting vascularization and cell survival, in turn reducing wall thinning and preventing dilatation and heart failure. Gene therapy is not a specific topic of this chapter, in which the focus will be on bioreactors for cell expansion and engineering of cardiac tissues for cardiac tissue regeneration. Instead, we refer the reader to excellent reviews [1–3].