Why the study?
Does the type of aortic valve replacement (bioprosthetic, Ross procedure, or mechanical) affect maternal, fetal, and cardiac outcomes during and after pregnancy?
Observational (n=16)
No
Does the type of aortic valve replacement (bioprosthetic, Ross procedure, or mechanical) affect maternal, fetal, and cardiac outcomes during and after pregnancy?
In women of childbearing age requiring aortic valve replacement, mechanical valves are associated with significantly higher maternal and fetal complications during pregnancy compared to bioprosthetic valves or the Ross procedure, with no significant difference in structural valve deterioration over short-term follow-up.
Supports preferring bioprosthetic valves or Ross procedure in women planning pregnancy; leaves open need for randomized durability data.
OBJECTIVES: To compare the maternal, fetal and cardiac outcomes in women who have undergone aortic valve replacement. METHOD: Retrospective observational study of all women with aortic valve replacement, who underwent a pregnancy (1998-2012). Maternal-, fetal- and valve-related cardiac outcomes were assessed. RESULTS: Thirty-two pregnancies in 16 women with aortic valve replacement (nine bioprosthetic, six Ross and 17 mechanical) were evaluated. There were no adverse maternal events in the bioprosthetic and Ross groups but three in the mechanical group. Fetal loss rate was highest in the mechanical valve pregnancies (53%). One woman in the bioprosthetic group needed valve re-operation, and one woman in the mechanical valve group died. There was no difference in the change of Vmax over the follow-up between the valves (p = 0.25). CONCLUSIONS: There was no difference in deterioration between aortic valve replacements during and after pregnancy. The highest risk of maternal and fetal complications occurred in the mechanical valve group.
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Basude et al. (2014) conducted an observational in Aortic valve replacement in pregnancy (n=16). Mechanical aortic valve replacement vs. Bioprosthetic valve or Ross procedure was evaluated on Difference in the change of maximum trans-prosthetic jet velocity (Vmax) over follow-up between valve types (p=0.25).
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