This 2026 meta-analysis pooled 13 studies, including 356 pregnancies in 251 women after aortic valve replacement (AVR). Pregnancy outcomes differed substantially by valve type. Mechanical prostheses carried the highest maternal risk, with maternal death and valve thrombosis reported only in this group and also had the lowest live birth rate at about 72 percent. In contrast, pulmonary autografts and homografts showed the most favorable overall maternal and fetal profiles, with live birth rates around 91 percent to 92 percent and fewer valve–related complications. Bioprostheses performed intermediately, with acceptable pregnancy outcomes but some risk of structural valve deterioration and reintervention. Overall, for women of childbearing age requiring AVR, tissue-based options, particularly autografts and homografts, may appear more pregnancy compatible than mechanical valves.
