During the period 1988–2001, the dominant paradigm centered on graft-derived regeneration to replace damaged myocardium, leveraging skeletal myoblasts, fetal cardiomyocytes, satellite cells, and embryonic stem cell–derived cardiomyocytes across species. Studies emphasized graft-host integration and durability, with ultrastructural fusion and long-term viability observed in syngeneic and diseased hosts. Molecular modulation through growth factors and lineage engineering, including transforming growth factor beta 1, MyoD, and basic fibroblast growth factor, tuned graft outcomes, while delivery strategies expanded myocardial seeding via intracoronary and arterial routes and introduced novel transplantation approaches.