Nanoscaffolds for Guided Cardiac Repair: The New Therapeutic Challenge of Regenerative Medicine

Table 2

Advantages and disadvantages of novel tissue engineering technologies for the treatment of heart diseases.

Approach	Advantages	Disadvantages
Cell sheet engineering	(i) Elimination of the use of biodegradable scaffolds, increased cell-to-cell connections, and reduced inflammatory responses; (ii) Noninvasive cells harvesting as intact monolayer sheets: cultured cells detach spontaneously by lowering temperature, thus avoiding the use of proteolytic enzymes; (iii) Harvested cell sheets can be easily transferred and directly attached to the host tissue; (iv) Ability to layer the harvested cell sheets: rapid cell-to-cell connections between the layers	(i) Transplantation of cell sheets alone cannot provide the proper mechanical strength necessary for replacing the infarcted myocardium; (ii) Need to rely on open surgery
Cell sheet fragments	(i) No use of proteolytic enzymes when harvesting cells; (ii) Injectable without open surgical methods; (iii) Good ability on cell attachment and proliferation when transferred to other surfaces; (iv) High cell retention in the infarcted myocardium	(i) Lack of a controlled delivery inside vessels; (ii) Risk of thrombosis inside vessels
Bioengineered cardiac patches	(i) Integration of the advantages of tissue-engineered scaffolds and cell sheets; (ii) Ability to provide the required mechanical strength to support seeded cell sheet systems; (iii) Prevention of cell loss to augment cell transfer efficiency, thus allowing a site-directed repair	(i) Immunogenicity caused by residual degraded scaffolds; (ii) Invasive open chest surgery; (iii) Materials should be optimized according to the cell source