- The ability to engineer or regenerate lost myocardial tissue caused by injury, aging, disease, or genetic abnormality holds great promise. The vision is to generate significant mass of functional heart muscle tissue. However, the area of myocardial tissue engineering still faces significant difficulties. Scientists are still searching for cell types other than cardiomyocytes. Novel approaches are warranted for material processing to create bioactive scaffolds, which would allow composition of the evolving myocardial structure. There is a need for development of strategies to promote vascularization and/or innervations within engineered myocardial tissue. Other important goals include achievement of immunologic tolerance for engineered constructs and increased understanding of the basic principles governing tissue formation, function, and failure, including the assembly of multiple cell types and biomaterials into multidimensional structures that mimic the architecture and function of native myocardial tissue.