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REVIEW ARTICLE

Bioprinting in cardiovascular tissue engineering:

a review

1,2
1,2
1,2
Jia Min Lee , Swee Leong Sing , Edgar Yong Sheng Tan and Wai Yee Yeong 1,2*
1 School of Mechanical and Aerospace Engineering, Nanyang Technological University, 50 Nanyang Avenue, Singapore
639798, Singapore
2 Singapore Centre for 3D Printing (SC3DP), School of Mechanical and Aerospace Engineering, Nanyang Technologi-
cal University (NTU), 50 Nanyang Avenue, Singapore 639798, Singapore

Abstract: Fabrication techniques for cardiac tissue engineering have been evolving around scaffold-based and scaf-
fold-free approaches. Conventional fabrication approaches lack control over scalability and homogeneous cell distribu-
tion. Bioprinting provides a technological platform for controlled deposition of biomaterials, cells, and biological fac-
tors in an organized fashion. Bioprinting is capable of alternating heterogeneous cell printing, printing anatomical rele-
vant structure and microchannels resembling vasculature network. These are essential features of an engineered cardiac
tissue. Bioprinting can potentially build engineered cardiac construct that resembles native tissue across macro to na-
noscale.
Keywords: Bioprinting, 3D printing, tissue engineering, cardiovascular tissue, scaffolds

*Correspondence to: Wai Yee Yeong, Singapore Centre for 3D Printing (SC3DP), School of Mechanical and Aerospace Engineering,
Nanyang Technological University (NTU), 50 Nanyang Avenue, Singapore 639798, Singapore; Email: wyyeong@ntu.edu.sg

Received: April 02, 2016; Accepted: June 14, 2016; Published Online: July 24, 2016
Citation: Lee J M, Sing S L , Tan E Y S, et al., 2016, Bioprinting in cardiovascular tissue engineering: a review. International Jour-
nal of Bioprinting, vol.2(2):27–36. http://dx.doi.org/10.18063/IJB.2016.02.006.

[1]
1. Introduction heart failure in patients . A plausible solution re-
A pects of the native myocardium.
quires looking at the biological and architectural as-
s one of the world’s leading causes of death,
cardiovascular disease possesses a relatively
The human heart comprises of approximately two
large market in regenerative medicine indus-
try. Due to medical advances, the mortality rates re- billion cells [3,4] with intricate myocardium architecture
comprising of non-cardiomyocytes cells and fibrillary
lated to cardiovascular diseases such as acute coronary structure. The heart comprises of four distinct layers
syndrome, congenital heart disease, uncontrolled ranging from pericardium (outer), epicardium, myo-
hypertension and arrhythmias have decreased in the cardium, and endocardium (inner). Each distinct layer
[1]
past decade . Despite these improvements, deaths comprises of myocardial laminar sheets with muscular
[5]
caused by heart failure still remain high with half of fibres of three to four cell layer thick . These laminar
heart failure patients dying within five years after di- layers, also known as sheetlets, re-orientates and con-
[6]
[2]
agnosis . The stagnation in heart failure mortality can tributes to wall thickening during systolic shortening .
be attributed to repeated episodes of cardiovascular Damaged myocardium cannot be restored on its own
diseases, even with previous intervention. This sug- as native cardiomyocytes are limited in regenerative
gests a plausible scenario where the root of the prob- abilities. Hence, cardiac tissue engineering aims to
lem has not been cured despite reduction in risk of provide biological solutions to restore the ill-function-

Bioprinting in cardiovascular tissue engineering: a review. © 2016 Jia Min Lee, et al. This is an Open Access article distributed under the terms of the
Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), permitting all
non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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