2020 Top 10 Original Articles in the Arquivos Brasileiros de Cardiologia and the Revista Portuguesa de Cardiologia

Predicting the Burden for Surgical Aortic Valve Replacement in a Tertiary Centre: The Impact of Aged Populations for the Next Decades

Background/Objectives: The incidence of aortic stenosis (AS) is predicted to rise with the aging population, emerging as a growing public health challenge in developed countries, leading to an increased demand for intervention. Our aim is to predict the evolution of proposed cases for SAVR in the geographic referral area of our tertiary hospital until 2041. Methods: We used data from the Portuguese Census for 2001, 2011, and 2021 to analyze the resident population within the Cardiothoracic Surgery Department's referral area. Applying population projection methods (rate of geometric growth), we projected demographic trends over 20 years, from 2021 to 2041. Our analysis focused on AS cases who underwent SAVR in our department between 2001-2011 and 2011-2021. Results: Between 2001 and 2021, there was an increase in the overall population, particularly among the elderly (1.4% growth rate in the population ≥ 65 years old). The aging index increased from 128.4 (110.5-180.6) in 2001 to 189.1 (155.9-222.5) in 2021 (p-value < 0.001). Similarly, the longevity index significantly increased between 2001 [42.6 (40.8-44.80)] and 2021 [49.30 (47.7-51.8)] (p-value < 0.001). The number of SAVRs performed increased, with a mean increase of 8.11 surgeries/year (R2 = 0.6457, p < 0.001). By 2041, our referral center will increase SAVR by at least 51 surgeries/year in a decreasing growth rate scenario, and 67 surgeries/year in a growth rate stagnation scenario. Conclusions: The ongoing trend of population aging will increase the demand for healthcare resources, particularly within the cardiovascular domain. Accurately assessing the volume of SAVR is imperative for reformulating strategies to address the increasing demand effectively.