Discarded relationship between deaths and waiting list for cardiac surgery

A Inspection-General of Health Activities (IGAS) found no relationship between the deaths of patients at Hospital de Santo António in Porto and the fact that they are on a waiting list for cardiac surgery at the Gaia/Espinho unit.

According to a clarification consulted today by Lusa, IGAS concluded the process of investigating the death of 10 users of the Local Health Unit of Santo António (ULSSA) eligible for cardiac surgery or percutaneous aortic valve implant (TAVI) referenced to the Local Health Unit of Gaia/Espinho (ULSGE), between 2022 and 2025, concluding that “not enough evidence was collected to confirm (...) an association between death (...) and waiting list for cardiac surgery”.

“In most of the situations analyzed, at the time of death, patients were under follow-up, evaluation or treatment in ULSGE or there was no established indication for surgery or TAVI, not yet accepted or placed on a waiting list for the procedure, in some cases considering the relationship between the expected clinical benefit and the risk of intervention that was not favorable”, reads in the conclusions of the process.

Lusa contacted the two hospitals and is awaiting an answer, in particular to the question whether the possibility already mentioned on previous occasions by ULS Santo António is a reference center affiliated with the support of ULS Gaia/Espinho.

At the origin of this case, initiated by an order of the inspector-general on April 6, there are reports of alleged deaths of patients while awaiting clinical intervention at ULSSA, patients who are “in general” referred to ULSGE, one of the units in the North to which users who need cardiac surgery or placement of TAVI are referred.

In an interview with RTP, the Director of Cardiology at ULS Santo António, André Luz, said in February that 10 patients died in the last three years due to a “too high waiting list” only in this Porto hospital.

On that occasion, ULS Santo António was given the ambition to create a reference centre in this area.

Currently, patients who need interventions in this area are referred to the reference centers of the São João ULS, in Porto, ULS of Vila Nova de Gaia/Espinho, as well as of the ULS Braga, unit that in April was working at 20% of its capacity, it is expected to reach the full until the end of the year.

Also on this occasion the Order of Doctors and directors of services, namely Gaia and São João, warned of a possible emptying of human resources if a new reference center to the North were to be created.

In the clarification, the GAI states that “in situations in which patients were evaluated and accepted for surgery or TAVI and the procedure did not come to fruition, death occurred shortly after the decision, and there are no elements in which to relate death to a possible delay in performing TAVI”.

The inspector-general shall, however, make recommendations: “Improving areas have been identified, particularly in the context of interhospital referral, requiring the existence of updated referral protocols (...)”.

The IGAS recommends that the necessary complementary diagnostic means “to avoid delaying or rescheduling of surgeries or procedures” be carried out “as soon as possible” and says that “the need to organize structured waiting lists for TAVI has also been established”.

“[This to] ensure the transparency of the processes, avoid discrepancies regarding the reference dates and show that the performance of the procedures, after indication, occurs in clinically acceptable response times”, complete.

On April 22, heard in parliament, the Secretary of State for Health, Ana Povo, said that almost 330 patients died, between 2021 and 2025, awaiting cardiac surgery.

Ana Povo also argued that “we need to look again at the networks, taking into account all installed capacity”.

On 30 March, on a visit to Maia, the Health Minister, Ana Paula Martins, admitted to preparing revisions in the legislation and the creation of special ordinances to speed up waiting times in surgeries, particularly in the heart.

Before, in February, it was reported that four directors of cardiology service from four hospitals in the North (Santo António, Tâmega and Sousa, Matosinhos and Trás-os-Montes and Alto Douro) subscribed a letter addressed to Ana Paula Martins about the panorama in cardiac surgery in the region in which they warned the waiting list.