haja um aumento de cirurgia para doencavalvar degenerativa nos proximos anos.Apesar dos avancos recentes, aepidemiologia de cirurgia cardiaca valvar no pais ainda se assemelha mais aospaises em desenvolvimento do que nos paises desenvolvidos. A cirurgia valvarpara doenca cardiaca reumatica ainda e realizada bem mais do que para a doencadegenerativa.Dessa forma a revisao mostraque o pais sofrera grandes alteracoes no perfil dos pacientes submetidos acirurgia valvar ao longo dos anos, e que a desigualdade social ainda e oprincipal determinante para o desenvolvimento da valvopatia e que acoesintegradas para reduzir a desigualdade social sao necessarias. 5. REFERENCIA BIBLIOGRAFICA1- Alpert J.S. Acute aortic insufficiency. In:Alpert J.S, Dalen J.E, Rahimtoola S.H.(eds.). Valvular heart disease. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2000.p.269-89. 2- BonowR.O, Carabello B.A, Chatterjee K, de Leon A.C.J.r, Faxon D.P, Freed M.D. Focused update incorporatedinto the ACC/AHA 2006 guidelines for the management of patients with valvularheart disease: a report of the American College of Cardiology/American HeartAssociation Task Force on Practice Guidelines (Writing Committee to Revise the1998 Guidelines for the Management of Patients With Valvular Heart Disease):endorsed by the Society of Cardiovascular Anesthesiologists, Society forCardiovascular Angiography and Interventions, and Society of Thoracic Surgeons.Circulation. 2008;118(15):e523-661.3- ChandrashekharY, Westaby S, Narula J. Mitral stenosis. Lancet. 2009;374(9697):1271-83.4- Costa L.P,Domiciano D.S, Pereira R.M.R. Caracteristicasdemograficas, clinicas, laboratoriais e radiologicas da febre reumatica noBrasil: revisao sistematica. RevBras Reumatol. 2009;49(5):606-16.5- Cotran R.S,Kumar V, Robbins S.L. Patologia: basespatologicas das doencas. 7a ed. Rio de Janeiro: Elsevier;2005. p.618-26.6- DanielsS.J, Mintz G.S, Kotler M.N. Rheumatic tricuspid valve disease: two-dimensionalechocardiographic, hemodynamic, and angiographic correlations. Am J Cardiol. 1983;51(3):492-6.7- FlackJ.M, Kvasnicka J.H, Gardin J.M, Gidding S.S, Manolio T.A, Jacobs D.R Jr. Anthropometric and physiologiccorrelates of mitral valve prolapse in a biethnic cohort of young adults: theCARDIA study. Am Heart J. 1999;138(3Pt1):486-92. 8- Fontes R.D, Salerno H.D, Hijo A.V, Najjar A,Scala L.C, Farah M.C, et al. Remodelacao cirurgica da valva aortica. Rev Bras Cir Cardiovasc. 2001;16(3):212-7. 9- Freeman R.V, Otto C.M. Spectrum of calcific aortic valve disease: pathogenesis, diseaseprogression, and treatment strategies. Circulation. 2005;111(24):3316-26.10- Gaudino M, Anselmi A, Glieca F,Tsiopoulos V, Pragliola C, Morelli M, et al. Contemporary results for isolated aortic valvesurgery.Thorac Cardiovasc Surg. 2011;59(4):229-32.11- GheorghiadeM, Braunwald E. Hospitalizations for heart failure in theUnited States-a sign of hope. JAMA 2011;306:1705-6. Erratum in: JAMA 2012; 307:563.12- Goldman L, Ausiello D. Cecil Medicina. 23a ed. Rio de Janeiro:Elsevier; 2009.p.612-26.13- Gomez-Doblas J.J. Valvulopatias em la mujer: diferencias de sexo em Espana. Rev EspCardiol. 2008; 8 (Supl.): 42D-48D.14- Hauck A.J, Freeman D.P, Ackermann D.M,Danielson G.K, Edwards W.D. Surgical pathology of the tricuspid valve: a study of 363 casesspanning 25 years. Mayo Clin Proc. 1988;63(9):851-63.15- HuffmanM.D, Bonow R.O. Clinical practice guidelinesand scientific evidence. JAMA. 2009; 302(2):144-5.16- Iung B,Vahanian A. Epidemiology of valvular heart disease inthe adult. Nat Rev Cardiol. 2011; 8: 162172.17- Khot U.N, Novaro G.M, Popovic Z.B, Mills R.M,Thomas J.D, Tuzcu E.M, et al. Nitroprusside in critically ill patients with left ventriculardysfunction and aortic stenosis. N Engl J Med. 2003;348(18):1756-63.18- Kuntz R.E, Tosteson A.N, Berman A.D, GoldmanL, Gordon P.C, Leonard B.M, et al. Predictors of event-free survival afterballoon aortic valvuloplasty. N Engl J Med. 1991;325(1):17-23.19- Kvidal P, Bergstrom R, Horte L.G,