The following is a summary of “Dissemination and implementation analysis of the Ross procedure in adults: time to update the guidelines?,” published in the December 2023 issue of Cardiology by Bilodeau et al.
The field of dissemination and implementation (D&I) strives to enhance care quality by overcoming barriers to integrating research and evidence-based practices into clinical routines, recognizing that therapy failures may stem from imperfect implementation rather than lack of efficacy.
Researchers conducted a retrospective study to examine how the historical context of the Ross procedure impacts its D&I.
They established a contextual baseline of the Ross procedure from its inception in the literature to significant publications post the 2017 valvular heart disease guidelines. The evaluation of D&I utilized the Consolidated Framework for Implementation Research (CFIR), incorporating constructs from all five domains to delineate critical determinants.
The result showed that the five CFIR domains are associated with factors influencing the diverse history of enthusiasm and acceptance of the Ross procedure. The intricate nature of Ross necessitated adaptation for optimization, revealing a significant correlation between center volume and outcomes, a consideration overlooked in non-contemporary studies. Subsequent outcomes from these studies impacted the social and cultural contexts within the aortic surgery community, contributing to organizational uncertainty and a gradual assimilation of guidelines.
Investigators concluded that underestimating the procedure’s complexity, patient selection nuances, and surgeon specialization hampered the Ross procedure’s D&I, leading to the dismissal of a valuable option due to mistaken assumptions about its effectiveness.
Source: cts.springeropen.com/articles/10.1186/s43057-023-00119-5