RESUMO

A new species of the genus Gammarus Fabricius, 1775 is described from Lake Tong Tso, an extreme high-altitude lake in the Qinghai-Tibetan Plateau. Gammarus pontualsp. nov. is considered part of the Gammarus lacustris G.O. Sars, 1863 group, which is characterized by having the inner ramus of uropod 3 longer than half the length of the outer ramus, and by having both rami covered with plumose setae. The new species stands apart from their congeners, mainly, by the following combination of characters: head with cephalic lateral lobe truncated; gnathopods 1-2 propodus weakly armed, with 1 stout seta defining palm; palm longer than posterior margin of propodus, with 1 main stout seta medially; pereopods 5-7 basis slender, posterior margin crenulate; epimeral plate 1 posterior margin produced into a short spine, facial ridge present; epimeral plates 2-3 posteroventral corner sharply pointed; uropod 3 rami covered with plumose setae, inner ramus about 80% the length of the outer ramus; telson apex with 2 stout setae on each side.(AU)

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Abstract A new species of the genus Gammarus Fabricius, 1775 is described from Lake Tong Tso, an extreme high-altitude lake in the Qinghai-Tibetan Plateau. Gammarus pontual sp. nov. is considered part of the Gammarus lacustris G.O. Sars, 1863 group, which is characterized by having the inner ramus of uropod 3 longer than half the length of the outer ramus, and by having both rami covered with plumose setae. The new species stands apart from their congeners, mainly, by the following combination of characters: head with cephalic lateral lobe truncated; gnathopods 1-2 propodus weakly armed, with 1 stout seta defining palm; palm longer than posterior margin of propodus, with 1 main stout seta medially; pereopods 5-7 basis slender, posterior margin crenulate; epimeral plate 1 posterior margin produced into a short spine, facial ridge present; epimeral plates 2-3 posteroventral corner sharply pointed; uropod 3 rami covered with plumose setae, inner ramus about 80% the length of the outer ramus; telson apex with 2 stout setae on each side.

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INTRODUÇÃO: A valvotomia mitral percutânea por balão é um procedimento seguro e eficaz em pacientes com estenose mitral grave sintomática selecionados, com resultados imediatos e a longo prazo semelhantes aos da intervenção cirúrgica. Este estudo tem o objetivo de descrever os resultados muito tardios das primeiras valvotomias mitrais percutâneas por balão realizadas em nossa instituição e identificar os fatores preditores de reestenose. MÉTODOS: No período de 1987 a 1991, 200 pacientes consecutivos foram submetidos a valvotomia mitral percutânea por balão. Avaliações clínica e ecocardiográfica foram realizadas antes do procedimento, 48 horas após e, então, anualmente. RESULTADOS: A média de idade foi de 32 ± 12 anos, 86,5% eram do sexo feminino e 80,5% encontravam-se em classe funcional III ou IV da New York Heart Association. A média do escore de Wilkins foi de 7,6 ± 1,2 e o sucesso do procedimento ocorreu em 87,5% (175/200) dos pacientes. Durante o seguimento, foram acompanhados 129 pacientes (74%) por 140 ± 79 meses. Reestenose após o primeiro procedimento ocorreu em 46,5% (60/129) dos pacientes, sendo realizada uma segunda valvotomia mitral percutânea por balão em 25 pacientes, uma terceira em 4 pacientes, e uma quarta em 1 paciente. Em cinco anos, a probabilidade livre de reestenose foi de 85%, em 10 anos foi de 60% e em 20 anos, de 36%. O diâmetro do átrio esquerdo (P = 0,034) e o gradiente transvalvar mitral tanto pré (P = 0,013) como pós-procedimento (P = 0,038) foram preditores de reestenose. CONCLUSÕES: Em seguimento clínico muito tardio, a valvotomia mitral percutânea por balão mostrou que os resultados são duradouros em mais de um terço dos pacientes e que a repetição do procedimento pode ser realizada com segurança em pacientes selecionados. A identificação dos preditores de reestenose é útil para guiar a seleção de casos para o procedimento.

BACKGROUND: Percutaneous balloon mitral valvotomy is safe and effective in patients with severe symptomatic mitral stenosis with immediate and long-term results comparable to those of surgical intervention. This study was aimed at reporting the very late follow-up results of the first percutaneous balloon mitral valvotomies performed at our institution and at identifying predictive factors of restenosis. METHODS: From 1987 to 1991, 200 consecutive patients were submitted to percutaneous balloon mitral valvotomy. Clinical and echocardiographic evaluations were performed prior to the procedure, 48 hours after the procedure and annually thereafter. RESULTS: Mean age was 32 ± 12 years; 86.5% were female and 80.5% were in New York Heart Association functional class III or IV. Mean Wilkins score was 7.6 ± 1.2 and procedure success was observed in 87.5% (175/200) of the patients. During follow-up, 129 patients (74%) were followed up for 140 ± 79 months. Restenosis was observed after the first procedure in 46.5% (60/129) patients and a second percutaneous balloon mitral valvotomy was performed in 25 patients, a third one in 4 patients and a fourth one in 1 patient. The probability of being restenosis-free was 85% at 5 years, 60% at 10 years and 36% at 20 years. Left atrial diameter (P = 0.034), and preoperative (P = 0.013) and postoperative (P = 0.038) transvalvar gradient were predictors of restenosis. CONCLUSIONS: In a very late clinical follow-up, percutaneous balloon mitral valvotomy provided long-lasting results in over one-third of the patients and showed that repeated procedures may be performed safely in selected patients. The identification of restenosis predictors is useful for patient selection.

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A insuficiência cardíaca crônica (IC), está na atualidade , entre as principais causas de morte e dependência física no Brasil e no mundo. Apresenta tratamento farmacológico bem definido e consagrado na prática clínica capaz de reduzir a mortalidade, mas não a morbidade plena desta enfermidade...

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