Techn. Hochsch., Diss., 2004--Aachen.

Background. Barlow’s mitral valve (MV) disease re- mains a surgical challenge. We compared short- and medium-term outcomes of neochordal (“loop”) versus edge-to-edge (“Alfieri”) minimally invasive MV repair in patients with Barlow’s disease. Methods. From January 2009 to April 2014, 123 consecutive patients with Barlow’s disease (defined as bileaflet billowing or prolapse [or both], excessive leaflet tissue, and annular dilatation with or without calcifica- tion) underwent minimally invasive MV operations for severe mitral regurgitation (MR) at our institution. Three patients (2.4%) underwent MV replacement during the study period and were excluded from subsequent anal- ysis. The loop MV repair technique was used in 68 pa- tients (55.3%) and an edge-to-edge repair was performed in 44 patients (35.8%). Patients who underwent a combi- nation of these 2 techniques (n [ 8 [6.5%]) were excluded. The median age was 48 years, and 62.5% of patients were men. Concomitant procedures included closure of a patent foramen ovale or atrial septal defect (n [ 19), tricuspid valve repair (n [ 5), and atrial fibril- lation ablation (n [ 15). Follow-up was performed 24.7 ± 17 months postoperatively and was 98% complete. Results. No deaths occurred perioperatively or during follow-up. Aortic cross-clamp time (64.1 ± 17.6 minutes versus 95.9 ± 29.5 minutes) and cardiopulmonary bypass (CPB) time (110.0 ± 24.2 minutes versus 146.4 ± 39.1 mi- nutes) were significantly shorter (p < 0.001) in patients who received edge-to-edge repair. Although patients who underwent edge-to-edge repair received a larger annulo- plasty ring (38.6 ± 1.5 mm versus 35.8 ± 2.7 mm; p < 0.001), the early postoperative resting mean gradients were higher(3.3±1.2mmHgversus2.6±1.2mmHg;p[ 0.007) and the mitral orifice area tended to be smaller in this group (2.8 ± 0.7 cm2 versus 3.0 ± 0.7 cm2; p [ 0.06). The amount of residual MR was similar between groups (0.3 ± 0.6 versus 0.6 ± 1.0 for edge-to-edge versus loop procedures, respectively; p [ 0.08). More than mild MR requiring early MV reoperation was present in 3 patients who underwent loop procedures (4.4%) and in no patients who had edge-to-edge procedures (p [ 0.51). During follow-up, 2 patients (1 in each group) required MV replacement for severe MR. The 4-year freedom from MV reoperation was 92.8% ± 5.0% in the Alfieri group compared with 90.9% ± 4.6% in the loop group (p [ 0.94). Conclusions. Minimally invasive MV repair can be accomplished with excellent early and medium-term outcomes in patients with Barlow’s disease. The edge- to-edge (Alfieri) repair can be performed with reduced operative times when compared with the loop technique, but it results in mildly increased transvalvular gradients and mildly decreased valve opening areas without any difference in residual MR.

Background. Barlow’s mitral valve (MV) disease re- mains a surgical challenge. We compared short- and medium-term outcomes of neochordal (“loop”) versus edge-to-edge (“Alfieri”) minimally invasive MV repair in patients with Barlow’s disease. Methods. From January 2009 to April 2014, 123 consecutive patients with Barlow’s disease (defined as bileaflet billowing or prolapse [or both], excessive leaflet tissue, and annular dilatation with or without calcifica- tion) underwent minimally invasive MV operations for severe mitral regurgitation (MR) at our institution. Three patients (2.4%) underwent MV replacement during the study period and were excluded from subsequent anal- ysis. The loop MV repair technique was used in 68 pa- tients (55.3%) and an edge-to-edge repair was performed in 44 patients (35.8%). Patients who underwent a combi- nation of these 2 techniques (n [ 8 [6.5%]) were excluded. The median age was 48 years, and 62.5% of patients were men. Concomitant procedures included closure of a patent foramen ovale or atrial septal defect (n [ 19), tricuspid valve repair (n [ 5), and atrial fibril- lation ablation (n [ 15). Follow-up was performed 24.7 ± 17 months postoperatively and was 98% complete. Results. No deaths occurred perioperatively or during follow-up. Aortic cross-clamp time (64.1 ± 17.6 minutes versus 95.9 ± 29.5 minutes) and cardiopulmonary bypass (CPB) time (110.0 ± 24.2 minutes versus 146.4 ± 39.1 mi- nutes) were significantly shorter (p < 0.001) in patients who received edge-to-edge repair. Although patients who underwent edge-to-edge repair received a larger annulo- plasty ring (38.6 ± 1.5 mm versus 35.8 ± 2.7 mm; p < 0.001), the early postoperative resting mean gradients were higher(3.3±1.2mmHgversus2.6±1.2mmHg;p[ 0.007) and the mitral orifice area tended to be smaller in this group (2.8 ± 0.7 cm2 versus 3.0 ± 0.7 cm2; p [ 0.06). The amount of residual MR was similar between groups (0.3 ± 0.6 versus 0.6 ± 1.0 for edge-to-edge versus loop procedures, respectively; p [ 0.08). More than mild MR requiring early MV reoperation was present in 3 patients who underwent loop procedures (4.4%) and in no patients who had edge-to-edge procedures (p [ 0.51). During follow-up, 2 patients (1 in each group) required MV replacement for severe MR. The 4-year freedom from MV reoperation was 92.8% ± 5.0% in the Alfieri group compared with 90.9% ± 4.6% in the loop group (p [ 0.94). Conclusions. Minimally invasive MV repair can be accomplished with excellent early and medium-term outcomes in patients with Barlow’s disease. The edge- to-edge (Alfieri) repair can be performed with reduced operative times when compared with the loop technique, but it results in mildly increased transvalvular gradients and mildly decreased valve opening areas without any difference in residual MR.

Im Rahmen dieser Arbeit wurde der Einfluss von passiven und elastischen Rückstromklappen, die auch als Flaps bezeichnet werden, auf einen Tragflügel mit NACA0020 Profil untersucht. Mithilfe einer Kraftwaage erfolgte zunächst die Erfassung der Auswirkungen auf das aerodynamische Verhalten des Tragflügels vor und nach der Strömungsablösung. Für ein detailliertes Verständnis wurde zusätzlich die Umströmung mit der Rauchdrahttechnik visualisiert und die Flapkinematik mit der Stereo Vision Technik aufgenommen. Es konnte festgestellt werden, dass die Vorderkantenflaps mit der geringsten Biegesteifigkeit die Gleitzahl des Tragflügels vor allem in abgelöster Strömung erhöhen. Die festgestellte Auftriebssteigerung resultiert aus der langsamen Aufstellbewegung und beschleunigten Anlegebewegung der Flaps, die eine einhergehende Reduzierung der turbulenten Ablösung verursachen. Die Ergebnisse der Arbeit liefern zahlreiche Erkenntnisse, die eine Übertragung des festgestellten Effekts auf andere technische Anwendungen erleichtern.:Abbildungsverzeichnis....................................................................... VII Tabellenverzeichnis............................................................................ XII Symbol- & Abkürzungsverzeichnis..................................................XVI 1 Einleitung......................................................................................... 1 2 Stand der Forschung........................................................................ 4 2.1 Wesentliche Aspekte von Profilumströmungen ................................. 4 2.2 Zusammenfassung essenzieller Aspekte von Tragflügeln mit Flaps ......7 3 Numerische Untersuchung der Profilumströmung....................... 13 3.1 Numerische Modell ......................................................................13 3.1.1 Grundgleichungen und Turbulenzmodell ..............................13 3.1.2 Randbedingungen und Diskretisierungsschema .....................16 3.2 Ergebnisse für das NACA0018 Profil .............................................18 3.3 Ergebnisse für das NACA0020 Profil .............................................19 3.4 Schlussfolgerung aus den Simulationen ..........................................22 4 Kraftmessungen an einem NACA0020 Tragflügel ....................... 23 4.1 Versuchsvorbereitung ...................................................................23 4.1.1 Windkanal ........................................................................23 4.1.2 Tragflügel und Funktionsweise der Kraftwaage .....................25 4.2 Messunsicherheit und Validierung .................................................27 4.3 Position der Flaps auf dem Tragflügel............................................ 31 4.3.1 Flapgeometrie und Flappositionen....................................... 31 4.3.2 Polardiagramme für variierende Flapposition........................34 4.4 Faserverstärkte Silikonflaps...........................................................36 4.4.1 Verwendeten Materialien ....................................................36 4.4.2 Polardiagramm für faserverstärkte Silikonflaps .....................38 4.5 Flapgeometrie .............................................................................40 4.5.1 Untersuchte Flapformen .....................................................40 4.5.2 Polardiagramm der untersuchten Flapformen ....................... 41 4.6 Wirkung der Flaps bei instationären Anströmung...........................43 4.6.1 Versuchsdurchführung ........................................................43 4.6.2 Ergebnisse der instationären Untersuchung...........................45 4.7 Schlussfolgerung der Auftriebs- und Widerstandsuntersuchungen .....47 5 Strömungsvisualisierung mithilfe der Rauchdrahttechnik........... 49 5.1 Experimenteller Aufbau ...............................................................49 5.2 Vorgehensweise bei der Auswertung...............................................50 5.3 Ergebnisse der Visualisierung........................................................ 51 6 Flapkantenkinematik..................................................................... 58 6.1 Versuchsaufbau und Versuchsdurchführung ....................................58 6.2 Bildauswertung ........................................................................... 61 6.3 Ergebnisse ..................................................................................62 6.3.1 VK Konfiguration - ohne Faserverstärkung...........................62 6.3.2 Bewegungsausführung des Vorderkantenflaps der VK-HK Konfiguration - ohne Faserverstärkung.......................................69 6.3.3 Bewegungsausführung des Vorderkantenflaps der VK-HK Konfiguration - mit Faserverstärkung ........................................75 6.3.4 Auswertung und Interpretation ...........................................82 7 Zusammenfassung.......................................................................... 87 8 Ausblick.......................................................................................... 89 Anhang ................................................................................................ 97 A Anhang 1....................................................................................97 B Anhang 2....................................................................................98 C Anhang 3....................................................................................99 / In the following study the effects of elastic and passive flaps were investigated on an airfoil with a NACA0020 profile. At first the aerodynamic performance of different configurations was measured with a force balance. In order to detect its effects before and after stall the angle of attack was varied during the experiments. For the configurations with increased aerodynamic performance additional experiments were carried out. The smoke wire visualization and stereo vision technique allowed a detailled insight in the flow around the NACA0020 profile and the flap movement. The results show that elastic flaps at the leading and trailing edge of the airfoil improve notably the airfoil performance in deep stall. Furthermore, the highest increase of the lift-to-drag ratio was achieved for the configuration with lowest bending stiffness. It was observed that the highest reduction of the turbulent separation region is caused by the flap movement. The increase of lift-to-drag ratio results from a slow upward and a fast downward motion of the elastic flap. The study delivers helpful information for transfer of the observed effect to other technical applications.:Abbildungsverzeichnis....................................................................... VII Tabellenverzeichnis............................................................................ XII Symbol- & Abkürzungsverzeichnis..................................................XVI 1 Einleitung......................................................................................... 1 2 Stand der Forschung........................................................................ 4 2.1 Wesentliche Aspekte von Profilumströmungen ................................. 4 2.2 Zusammenfassung essenzieller Aspekte von Tragflügeln mit Flaps ......7 3 Numerische Untersuchung der Profilumströmung....................... 13 3.1 Numerische Modell ......................................................................13 3.1.1 Grundgleichungen und Turbulenzmodell ..............................13 3.1.2 Randbedingungen und Diskretisierungsschema .....................16 3.2 Ergebnisse für das NACA0018 Profil .............................................18 3.3 Ergebnisse für das NACA0020 Profil .............................................19 3.4 Schlussfolgerung aus den Simulationen ..........................................22 4 Kraftmessungen an einem NACA0020 Tragflügel ....................... 23 4.1 Versuchsvorbereitung ...................................................................23 4.1.1 Windkanal ........................................................................23 4.1.2 Tragflügel und Funktionsweise der Kraftwaage .....................25 4.2 Messunsicherheit und Validierung .................................................27 4.3 Position der Flaps auf dem Tragflügel............................................ 31 4.3.1 Flapgeometrie und Flappositionen....................................... 31 4.3.2 Polardiagramme für variierende Flapposition........................34 4.4 Faserverstärkte Silikonflaps...........................................................36 4.4.1 Verwendeten Materialien ....................................................36 4.4.2 Polardiagramm für faserverstärkte Silikonflaps .....................38 4.5 Flapgeometrie .............................................................................40 4.5.1 Untersuchte Flapformen .....................................................40 4.5.2 Polardiagramm der untersuchten Flapformen ....................... 41 4.6 Wirkung der Flaps bei instationären Anströmung...........................43 4.6.1 Versuchsdurchführung ........................................................43 4.6.2 Ergebnisse der instationären Untersuchung...........................45 4.7 Schlussfolgerung der Auftriebs- und Widerstandsuntersuchungen .....47 5 Strömungsvisualisierung mithilfe der Rauchdrahttechnik........... 49 5.1 Experimenteller Aufbau ...............................................................49 5.2 Vorgehensweise bei der Auswertung...............................................50 5.3 Ergebnisse der Visualisierung........................................................ 51 6 Flapkantenkinematik..................................................................... 58 6.1 Versuchsaufbau und Versuchsdurchführung ....................................58 6.2 Bildauswertung ........................................................................... 61 6.3 Ergebnisse ..................................................................................62 6.3.1 VK Konfiguration - ohne Faserverstärkung...........................62 6.3.2 Bewegungsausführung des Vorderkantenflaps der VK-HK Konfiguration - ohne Faserverstärkung.......................................69 6.3.3 Bewegungsausführung des Vorderkantenflaps der VK-HK Konfiguration - mit Faserverstärkung ........................................75 6.3.4 Auswertung und Interpretation ...........................................82 7 Zusammenfassung.......................................................................... 87 8 Ausblick.......................................................................................... 89 Anhang ................................................................................................ 97 A Anhang 1....................................................................................97 B Anhang 2....................................................................................98 C Anhang 3....................................................................................99