TOPLINE

In a national registry study, about half of the women of childbearing age who underwent surgical aortic valve replacement with a bioprosthetic valve successfully gave birth to at least one child and experienced favorable delivery outcomes. However, rates of spontaneous abortion and reintervention appeared higher with bioprosthetic valves than with mechanical valves, according to a brief report published in JACC.

METHODOLOGY

• Researchers conducted an observational study using data from a Swedish registry to assess long-term pregnancy and cardiovascular outcomes after surgical aortic valve replacement in women of reproductive age.
• They included 251 women aged 18-40 years who underwent surgical aortic valve replacement between January 1997 and December 2024. Of these women, 93 received bioprosthetic valves and 158 received mechanical valves.
• Researchers assessed deliveries, in‑hospital spontaneous abortion, aortic valve reintervention, major bleeding, and death, with follow-up until death or September 2025.

TAKEAWAY

• The 15-year cumulative incidence of delivery was 54.0% among women who received bioprosthetic valves. At least one delivery occurred in 50.5% of women who received bioprosthetic valves compared with 9.5% of those who received mechanical valves.
• The 15-year cumulative incidence of spontaneous abortion was 12.6% among women who received bioprosthetic valves compared with 3.4% among those who received mechanical valves.
• Over 15 years, aortic valve reintervention was performed in 46.5% of women who received bioprosthetic valves vs 6.9% of those who received mechanical valves.
• The cumulative incidence of all-cause mortality at 15 years was 5.6% in women who received bioprosthetic valves and 12.7% in those who received mechanical valves.

IN PRACTICE

“Women of childbearing age undergoing bioprosthetic AVR had favorable delivery outcomes despite high reintervention rates. These data may help inform shared decision-making in this patient population,” the researchers of the study wrote.

SOURCE

The study was led by Ruixin Lu, MD, of Karolinska Institutet in Stockholm, Sweden. It was published online on July 1 as a brief report in JACC.

LIMITATIONS

Researchers lacked data on anticoagulation, fetal outcomes, international normalized ratio values, pregnancy intent, and echocardiographic follow-up. 

DISCLOSURES

The study received support from multiple organizations, including the Swedish Heart-Lung Foundation, Region Stockholm clinical postdoctoral appointment, Mats Kleberg Foundation, Karolinska Institutet Foundations and Funds, and Magnus Bergvall Foundation, and donations from the Schörling Foundation and Fredrik Lundberg. The authors declared having no relevant relationships.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.