Mitochondria-Loaded Janus Cardiac Patch for Myocardial Infarction Repair and Prevention of Tissue Adhesions

Mitochondrial dysfunction triggers cardiomyocyte injury and death after myocardial infarction (MI), and mitochondrial delivery via cardiac patches offers a promising strategy to restore mitochondrial function, thereby improving myocardial repair. However, current patches lack stable wet adhesion and are often monofunctional, failing to prevent tissue adhesion. Herein, we developed a Janus cardiac patch by combining bioadhesive and electrospun nanofibers. The inner layer exhibited strong wet adhesion with an adhesive strength of 55 kPa and interfacial toughness of 214 J m^-2, significantly surpassing commercial fibrin glue. Meanwhile, the outer layer, made of lubricating nanofibers, acted as a barrier against tissue adhesion. Importantly, the bioadhesive inner layer, loaded with adipose stem-cell-derived mitochondria, delivered mitochondria into cardiomyocytes via permeation, thereby enhancing mitochondrial function. <i>In vivo</i> studies using a rat MI model demonstrated that the Janus cardiac patch prevented tissue adhesion and facilitated myocardial repair. Spatial metabolomics analysis revealed that the patch improved energy metabolism in the infarcted myocardium, helping to restore the energy supply, which may have mediated the enhanced myocardial repair induced by the Janus cardiac patch. Our study introduces an approach for local mitochondrial delivery and highlights the potential of the Janus cardiac patch for treating MI.