Health Inspectors Cannot Confirm Ten Porto Heart Patients Died for Want of Timely Surgery, and Order a Deeper Inspection

The Inspeção-Geral das Atividades em Saúde (IGAS, the health inspectorate) could not confirm that ten heart patients from Porto's Santo António hospital died because they were not operated on in time, Público reported on 17 October. The inspector-general has now ordered a full inspection process to establish the facts. It also says referral between hospitals and the organisation of the waiting list must improve.

The ten patients were eligible for heart surgery or for a TAVI, a heart valve implanted through a catheter, and had been referred to the ULS de Gaia/Espinho (Gaia/Espinho Local Health Unit) between 2022 and 2025, Público said. The IGAS findings have not yet been published on the inspectorate's own website.

How the case started

On 19 February, the head of cardiology at the ULS de Santo António, André Luz, told RTP that ten patients had died in three years because the waiting list was too long. Santo António refers its heart surgery patients to the surgical centres at São João and Gaia/Espinho, and now also Braga, Lusa reported.

The inspectorate's own notice, dated 24 April, says it opened a clarification process (013/2026-ESC) on 6 April, after the press reports, to check whether ten patients had died between 2022 and 2025 because of an excessively long list. The Entidade Reguladora da Saúde (ERS, the health regulator) opened its own review of access to heart surgery on 25 February, Lusa reported. In April, the Secretary of State for Health told parliament that almost 330 patients had died between 2021 and 2025 while waiting for heart surgery nationally, according to Lusa. That figure does not by itself mean the wait caused the deaths.

A long list and almost no transfers

The ERS president told parliament in April that 2,703 people were waiting for heart surgery at the end of 2025, and that the legal maximum had been missed in more than 55 percent of cases in each of the last six quarters, Lusa reported. He also said no surgery vouchers or transfer notes were issued for heart surgery in 2025, because no other hospital had declared itself available to take the patients.

On 4 May the government published Portaria 205/2026/1, which set an 80 percent incentive rate for surgical teams operating, outside normal hours, on heart patients already past the legal limit. It applied until 30 September 2026.

What the law guarantees heart patients

Portaria 153/2017 sets the maximum guaranteed response times (tempos máximos de resposta garantidos, TMRG) for planned heart surgery, counted from the date the operation is formally proposed and accepted:

• 15 days for very high priority cases;
• 45 days for priority cases;
• 90 days for normal priority.

Under the SNS surgical waiting list manual, as described by the ERS, a patient whose hospital cannot operate in time should be transferred to another public or contracted hospital once 75 percent of the limit has passed at normal priority, or 50 percent at priority level. Very high priority patients can ask for a transfer from the fifth day. A transfer note offers a choice of public hospitals; a surgery voucher (vale cirurgia) adds private and social sector hospitals.

Patients on the list can ask their hospital for their priority level and the date they were registered for surgery, which together fix their deadline. For the wider picture, see our report on the patients past the legal limit for surgery and on Santo António's extra operating sessions.