Bacteriophage Therapy in Cardiovascular Medicine: A Paradigm Shift in the Prevention of Device-Related Infections

Cardiovascular implant infections significantly impact morbidity and mortality. Bacteriophage therapy has emerged as a potential strategy for device-related infection, particularly in biofilm-associated settings where conventional antimicrobial therapy is limited, often necessitating device removal. This review outlines phage treatment principles, including biofilm invasion, phage-antibiotic interaction, phage resistance, and infection protection mechanisms. We explore innovative approaches for using bacteriophages to treat infections around prosthetic vascular grafts, heart valves, left ventricular assist devices, and cardiac implantable electronic devices. Key issues in using bacteriophages for cardiovascular device infections include phage selection, resistance detection, phage production, regulatory aspects, and experimental models considering infection and device flow dynamics. Although clinical trials on phage therapy effectiveness are unavailable, its promise is significant.