Strategies for the chemical and biological functionalization of scaffolds for cardiac tissue-engineering. A review

The development of biomaterials for cardiac tissue engineering is challenging, primarily due to the requirement of achieving a surface with favorable characteristics that enhances cell attachment and maturation. The biomaterial surface plays a crucial role as it forms the interface between the scaffold (or cardiac patch) and the cells. In the field of cardiac tissue engineering, synthetic polymers (polyglycerol sebacate, polyethylene glycol, polyglycolic acid, poly-L-lactide (PLA), polyvinyl alcohol, polyhydrobutyrates, polycaprolactone, polyurethanes and poly N-isopropylacrylamide) have proven to exhibit better biodegradable and mechanical properties than natural materials. Despite they show a suitable biocompatible behaviour, most of them have poor cell attachment. These synthetic polymers are mostly hydrophobic and lack cell recognition sites, limiting their application. Therefore, biofunctionalization of these biomaterials to enhance cell attachment and cell material interaction is being heavily investigated. There are numerous approaches for functionalizing a material, which can be classified in mechanical, physical, chemical and biological. In this review recent studies and attempts to functionalize scaffolds in the context of cardiac tissue engineering, are discussed. Surface, morphological, chemical and biological modifications are introduced and development and results of novel promising strategies and techniques are discussed.