Directions in cardiovascular tissue engineering

The generation of tissue replacements or supplements for diseased tissue within the cardiovascular system has been the target of recent tissue engineering efforts. While clinically applicable methodologies remain to be achieved, important foundational experimentation has been performed in recent years to begin the move toward engineered tissue replacement therapy. Inadequacies of current valve, vessel, and other heart prostheses are reviewed briefly, followed by the discussion of selected progress in the supplementation or replacement of each cardiovascular component with tissue constructs. Topics addressed include the endothelialization of bio-prosthetic valves and synthetic vascular grafts, the generation of tissue valve leaflets and vascular conduits, the genetic manipulation of endothelial cells with implications for graft endothelialization, and cardiomyoplasty achieved through cellular and genetic means.