Cardiac tissue engineering.

The first 2 reviews in this series have described the defining properties of stem cells, their possible sources, and some initial attempts at their clinical use for tissue regeneration and repair. This third and final article in the series describes bioengineering methods for building physical structures to contain and organize implanted cells. The relevant theory is that appropriate physical supporting structures will help implanted cardiac stem cell populations organize themselves into functioning cardiac tissue that integrates physically and functionally with the receiving heart. The purpose of cardiac tissue engineering is to replace or repair injured heart muscle effectively. Supporting materials to create habitable spaces can provide the basic requirements of cardiac muscle cells. The design of such supporting materials influences the behavior of cells; the shape, dimensions, and chemistry of substrates affect such processes as attachment, cell signaling, and differentiation. As cardiac muscle cells flourish in artificial environments, they may become functional tissue with clinical value. This review summarizes the major bioengineering approaches for containing and organizing cardiac muscle cells and their potential to ameliorate total heart failure.