# The Long and Winding Road to Cardiac Regeneration
## 7 Future Directions
### Organs-on-Chips  
Extensive studies have been conducted to explore innovative approaches to regenerate cardiac tissue, and one particularly notable advancement is the use of chips, also known as'micro-engineered cardiac tissue,' to facilitate the process [336; 337; 338; 339; 340; 341]. These chips, which are small in size and comparable to a fingernail, have the remarkable ability to mimic the behavior of real human heart cells. By harnessing this technology, researchers have achieved the creation of 3D scaffolds that closely resemble the natural behavior of a functioning human heart [342; 343; 344; 345; 346]. The utilization of chips for cardiac regeneration offers several significant advantages over conventional approaches. Firstly, the cells integrated into the chips can self-renew, which enables them to spontaneously regenerate and repair themselves without external intervention [347]. This means that once the cardiac tissue is repaired using the chip, it can continue to function for extended periods without the need for further adjustments or interventions. This inherent capability of the cells embedded in the chips ensures long-term viability and functionality of the regenerated cardiac tissue. Moreover, chips have proven to be highly effective in repairing damaged cardiac tissue. By replicating the behavior of damaged cells, the chips can replace them with healthy cells, thus restoring the normal functionality of the tissue. This ability to mimic and replace damaged cells is a significant advantage, as it facilitates the restoration of cardiac function and promotes overall cardiac health [348]. Another notable benefit of chip-based cardiac regeneration is the reduction in the need for extensive human intervention. Traditional regenerative treatments often require long-term hospitalization for patients, which can be burdensome and costly. Additionally, invasive procedures carry a risk of infection and other complications. However, chip-based regeneration minimizes these concerns by eliminating the need for prolonged hospital stays and invasive interventions. This results in improved patient comfort, reduced healthcare costs, and a lower risk of complications. Furthermore, the use of chips in cardiac regeneration is relatively cost-effective and user-friendly. Chips can be manufactured at a reasonable cost, making them accessible to a wider range of healthcare providers and patients. Additionally, their small size and compatibility with existing medical technologies make them easy to incorporate into clinical practice. This user-friendly aspect allows for widespread adoption and implementation of chip-based cardiac regeneration techniques. Overall, the utilization of chips for cardiac regeneration presents a multitude of advantages. The self-renewing nature of the cells in the chips ensures long-term repair and functionality of the cardiac tissue. The ability of chips to replace effectively damaged cells promotes efficient tissue regeneration and restoration of cardiac function. By reducing the need for human intervention, chip-based regeneration mitigates the associated challenges and costs. These factors, coupled with the affordability and user-friendliness of chips, contribute to their increasing popularity as a promising approach in cardiac regeneration. With ongoing advancements and research in this field, it is expected that the use of chips for cardiac regeneration will continue to evolve and gain prominence in the coming years [349]. One of the most extensively studied and published areas of organ-on-chip technology is the development of cardiac or heart-on-chip models. These cardiac organ-on-chip systems aim to replicate the complex structure and function of the human heart, allowing researchers to study cardiac physiology, drug responses, disease mechanisms, and potential therapeutic interventions in a controlled and highly realistic in vitro setting. Several notable examples of cardiac organ-on-chip models have been published, demonstrating the versatility and effectiveness of this technology.