Abstract Body: Background: Cardiovascular disease remains the leading cause of mortality worldwide, with limited treatment options for patients suffering from myocardial infarction and end-stage heart failure. Traditional regenerative therapies, including pharmacological interventions and cell-based strategies, have shown limited efficacy in restoring functional heart tissue. Recent advancements in three-dimensional (3D) bioprinting have emerged as a transformative approach to fabricating functional cardiac tissues, enabling personalized regenerative solutions for transplantation and disease modeling. However, significant challenges remain in achieving vascularization, biomechanical integration, and large-scale tissue fabrication.

Methods: This review evaluates the latest developments in 3D bioprinting technologies, including extrusion-based, inkjet-based, and stereolithographic approaches, and their applications in cardiac tissue engineering. The role of biomaterials, bioinks, and stem cell-derived cardiomyocytes in enhancing printability, structural fidelity, and functional maturation of engineered cardiac tissues is critically analyzed. Additionally, emerging strategies to integrate vascular networks, improve electrophysiological coupling, and optimize patient-specific biofabrication are explored.

Results: Bioprinted cardiac patches demonstrate promising outcomes in restoring myocardial function and promoting neovascularization. Advances in decellularized extracellular matrix-based bioinks, coaxial printing for vascularized tissues, and microfluidic-assisted fabrication have improved cell survival and functional integration. However, arrhythmogenic risks, immune response challenges, and scalability limitations remain barriers to clinical translation. Studies highlight the importance of computational modeling and artificial intelligence-driven biofabrication in optimizing tissue architecture and predicting bioprinted construct viability.

Conclusion: The convergence of bioprinting technology, biomaterials, and precision medicine offers a novel approach to cardiac tissue engineering and transplantation. However, addressing vascularization, biomechanical compatibility, and regulatory approval is critical for clinical success. Future research should focus on scalable manufacturing, bioreactor-based maturation, and AI-assisted optimization to accelerate the clinical application of bioprinted cardiac tissues.