Bioengineers have considerably advanced cardiac scaffold engineering techniques to treat myocardial infarction, a form of cardiovascular disease and the leading cause of morbidity and mortality worldwide. However, it is still challenging to replicate structural specificity and variability of cardiac tissues with traditional bioengineering processes. In a new report on Science Advances, Haitao Cui and an interdisciplinary research team at the National Institute of Health, University of Maryland, and the George Washington University, U.S. developed a four-dimensional (4-D) cardiac patch with physiological adaptability. They used beam scanning stereolithography to print the construct and combined 4-D self-morphing with expandable microstructures to improve their biomechanical properties to integrate within the beating heart. The results showed improved vascularization and maturation of cardiomyocytes under physiologically relevant mechanical stimulation. The constructs were suited for use in a mouse model of chronic myocardial infarction (MI) with improved cell engraftment and vascular supply. The work provides an effective treatment strategy for MI and a cutting-edge bioengineering method to improve the structural design of complex tissues for organ regeneration.