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Review
. 2009 Jul;30(5):716-23.
doi: 10.1007/s00246-009-9405-6. Epub 2009 Mar 25.

Cardiac tissue engineering: implications for pediatric heart surgery

Wolfram-Hubertus Zimmermann  1 , Robert Cesnjevar
Affiliations
Review

Cardiac tissue engineering: implications for pediatric heart surgery

Wolfram-Hubertus Zimmermann et al. Pediatr Cardiol. 2009 Jul.

Abstract

Children with severe congenital malformations, such as single-ventricle anomalies, have a daunting prognosis. Heart transplantation would be a therapeutic option but is restricted due to a lack of suitable donor organs and, even in case of successful heart transplantation, lifelong immune suppression would frequently be associated with a number of serious side effects. As an alternative to heart transplantation and classical cardiac reconstructive surgery, tissue-engineered myocardium might become available to augment hypomorphic hearts and/or provide new muscle material for complex myocardial reconstruction. These potential applications of tissue engineered myocardium will, however, impose major challenges to cardiac tissue engineers as well as heart surgeons. This review will provide an overview of available cardiac tissue-engineering technologies, discuss limitations, and speculate on a potential application of tissue-engineered heart muscle in pediatric heart surgery.

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Figures

Fig. 1
Fig. 1
Tissue engineering modalities enabling the generation of large macroscopically contracting tissue constructs: (1) bioengineering approach [27, 42], (2) biological assembly approach [36, 57], (3) cell sheet approach [19, 46], and (4) decellularization–recellularization approach [39]
Fig. 2
Fig. 2
Muscle formation in EHT. Actin staining (white in [a], green in [b]) denotes the formation of a dense network of muscle strands, which might in some cases reach a diameter of up to 200 μm. Images from [57] (a) and [36] (b). (Color figure online)
Fig. 3
Fig. 3
Schematic drawings of potential applications of tissue-engineered myocardium (gray) for left ventricular augmentation (top) or single-ventricle septation (bottom) in children with HLHS or DILV, respectively. RV: right ventricle; LV: left ventricle; SV: single ventricle
See this image and copyright information in PMC

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