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Cardiovascular disease is one of the leading causes of death worldwide. Surgical techniques, including bridging, replacing, or plasticizing damaged tissue, need suitable grafts for these operations. The ideal source is autologously obtained grafts, which, however, require another invasive approach, and there are not enough of them, or they do not meet the optimal anatomical form. Allogeneic grafts from cadaveric donors are not immediately available for acute interventions. Synthetic replacements show good results in large arteries, but restenosis occurs in small diameter vessels and often require further reoperation. The use of tissue engineering methods to modify these replacements by cell colonization may provide their better patency. Furthermore, decellularized xenogeneic tissues are promising matrices for the development of tissue-engineered cardiovascular grafts. Due decellularization the immunogenic complex is minimized while maintaining a suitable building structure. In combination with recolonization with suitable cells using culture bioreactors, new functional cardiovascular replacements can be created. Endothelialization of the inner lumen is a crucial element in the formation of cardiovascular replacements. The effect of shear stress simulated in the bioreactor has a positive effect on...