Health-Related Quality of Life, Challenges, and Experiences of Patients With Congenital Heart Disease After Cardiac Catheterization - A Mixed-Methods Study

Sep 29, 2026

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Assessing health-related quality of life (HRQoL) in Pakistan for congenital heart disease (CHD) patients after cardiac catheterization, this mixed-methods study compared HRQoL of patients with CHD to age-matched siblings and examined lived experiences. Quantitative analyses used pediatric quality-of-life questionnaires from 120 case–control pairs; qualitative insights came from semistructured interviews. High HRQoL scores were found overall, with low scores linked to later diagnosis age and PREDIC3T categories, while interviews emphasized well-being, financial stability, and empathetic provider communication.

LanguageEnglish

CategoryHealthcare

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Pages9

Reading Time23 min

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Journal of the Society for Cardiovascular Angiography & Interventions 4 (2025) 103922 Original Research Health-Related Quality of Life, Challenges, and Experiences of Patients With Congenital Heart Disease After Cardiac Catheterization: A Mixed-Methods Study Fatima Ali, MBBS a, * ,†, Laila Akbar Ladak, PhD b,†, Asra Usmani, MD c, Mahnoor Javaid, MBBSd, Taha Anwar, BA e, Babar Sultan Hasan, MBBS a a Division of Cardio-thoracic Sciences, Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan; b School of Nursing, The Aga Khan University Hospital, Karachi, Pakistan; c Department of Pediatrics, Western Michigan University Homer Stryker M. D. School of Medicine, Kalamazoo, Michigan; d The Aga Khan University Medical College, Karachi, Pakistan; e Department of Pediatrics and Child Health, The Aga Khan University Hospital, Karachi, Pakistan | A B S T R A C T | | --- | | Background: In Pakistan, where health care resources for congenital heart disease (CHD) are expanding, this study aimed to assess the health-related quality of life (HRQoL), challenges, and experiences of patients with CHD after cardiac catheterization. Using a mixed-methods approach, quantitative arm compared the HRQoL of patients with CHD with that of age-matched siblings identified predictors of low HRQoL scores, and qualitative arm explored patient’s perceptions of quality of life, the challenges, and their experiences.
Methods: In this prospective, cross-sectional study conducted at The Aga Khan University Hospital, quantitative data were collected via pediatric qualityof-life questionnaires from 120 case–control pairs, while qualitative insights were gathered through semistructured interviews. Data analysis used descriptive stats, paired t tests, and content analysis for HRQoL themes.
Results: A total of 320 interviews were analyzed, including 120 patients with CHD, 120 age-matched siblings, and 80 parents. Quantitative data revealed high scores with no significant HRQoL differences between patients with CHD and controls. Minor differences were observed in physical and emotional domains, and higher-risk patients showed few concerns in cardiac-related HRQoL. Predictors such as age at diagnosis and Procedural Risk in Congenital Cardiac Catheterization (PREDIC3T) category were associated with low HRQoL scores. Qualitative thematic analysis highlighted the importance of physical and mental well-being, the impact of financial stability, and the need for empathetic communication from health care providers.
Conclusions: This study found high HRQoL scores in patients with CHD after cardiac catheterization, with significant associations of low scores to late age at diagnosis and PREDIC3T categories. Despite these positive outcomes, challenges like access to care and national support highlight the need for systemic improvements. | Introduction Congenital heart disease (CHD) affects approximately 1% of live births globally, with >90% of cases in low-income and middle-income countries (LMICs) .1,2 Since 1990, CHD prevalence has increased by 18.7%, largely due to advances in surgery and catheter-based interventions that have improved survival.3,4 Congenital cardiac catheterization interventions, ranging from simple to complex, may be used alone or alongside surgeries, such as patent ductus arteriosus (PDA) stenting before single-ventricle palliation, or pulmonary artery stenting after tetralogy of Fallot repair.5 While widely practiced in both high-income countries and LMICs,5 ,6 most published data on congenital cardiac interventions come from high-income countries and primarily address procedural aspects such as risk prediction,7 ,8 adverse events,9 radiation exposure,10 performance, 11 and global quality improvement initiatives.5 ,6 , 12 As a result, data on patient-centered outcomes, such as health-related quality of life (HRQoL),13 , 14 remain limited. The HRQoL reflects a patient’s perceived physical, emotional, and social w

FAQs

What was the purpose of assessing HRQoL in CHD patients after cardiac catheterization?

To evaluate health-related quality of life, challenges, and patient experiences in a setting where resources for CHD are expanding, by comparing patients with age-matched siblings.

How were quantitative and qualitative data collected in the study?

Quantitative data were gathered using pediatric quality-of-life questionnaires from 120 case–control pairs, and qualitative insights were obtained through semistructured interviews.

Which factors were associated with low HRQoL scores?

Low HRQoL scores were associated with later age at diagnosis and Procedural Risk in Congenital Cardiac Catheterization (PREDIC3T) categories.

Sep 29, 2026

Uploaded by Jacob