The mitral valve, located between the heart’s upper and lower left chambers, functions like a one-way door, ensuring blood flows forward. When the valve is damaged, often causing mitral regurgitation where blood leaks backward, surgeons generally prefer to repair the native valve rather than replace it. Understanding the time commitment for this procedure is complex because the total time spent in the operating suite is much longer than the time the surgeon is actively working. While the duration is highly variable depending on the individual case and surgical approach, the core repair phase typically falls within a window of two to five hours.
The Core Surgical Timeframe
The core surgical timeframe is the time dedicated to the actual valve repair. This phase begins when the patient’s heart is intentionally stopped, a state known as ischemic arrest, and circulation is maintained by a heart-lung machine, or cardiopulmonary bypass. Using the bypass machine allows the surgeon to operate on a still, bloodless heart, which is necessary for delicate valve reconstruction.
For a standard open-heart approach, which involves a sternotomy, the time spent actively performing the repair, including going on and off bypass, generally ranges from three to five hours. If a minimally invasive technique is used, such as a small incision on the side of the chest, the core repair time is often between two and four hours. During this window, the surgical team performs techniques like annuloplasty, where a ring is placed around the valve opening, or leaflet resection and chordal replacement to fix damaged flaps.
Variables Influencing Operation Length
The complexity of the patient’s underlying valve disease is the primary factor that can push the duration beyond the typical core timeframe. For instance, a simple prolapse of a single leaflet requires less time than extensive damage involving multiple parts of the valve structure. If the valve tissue has significant calcification, the surgeon must spend additional time carefully removing the hardened calcium deposits before proceeding with the repair.
The choice of surgical technique introduces variability; for instance, minimally invasive approaches often require a longer initial setup time to position specialized instruments and camera ports, potentially adding time to the overall procedure. Patient-specific factors can also extend the timeline. Previous heart surgery results in scar tissue, which makes accessing the heart more challenging. If the patient requires an additional procedure, such as a coronary artery bypass graft, the total surgical duration will be significantly increased.
The Full Operating Suite Timeline
The total time the patient spends in the operating suite is substantially longer than the core surgical time, often ranging from five to eight hours. This comprehensive timeline accounts for all preparatory and closing steps. The process begins with the pre-incision phase, where the patient receives general anesthesia, and the surgical team places monitoring lines and the breathing tube. This setup process can take up to two hours.
Once the patient is prepared, surgical access is created, and connections to the cardiopulmonary bypass machine are established, leading into the core repair phase. Following the successful valve repair, the heart is restarted, and the patient is gradually weaned off the heart-lung machine. The surgical team then closes the incisions, which includes wiring the sternum back together for an open-heart procedure or suturing smaller incisions in a minimally invasive case. Finally, the patient is stabilized while the care team prepares them for transfer to the Intensive Care Unit.