Common heart diseases that occur during pregnancy are congenital heart disease (atrial septal defect, ventricular septal defect), valvular disease (mitral stenosis, mitral valve closure insufficiency), cardiac tumors (cardiac mucinous tumors), and aortic coarctation. After pregnancy, the load on the heart of a pregnant woman increases by 30-50%. If there was a heart disease before pregnancy, or if the heart disease develops after pregnancy, the impaired function of the heart itself, combined with the additional demands increased by pregnancy, will pose a threat to the life of the pregnant woman. For the mother-to-be, should she give up the fetus and abort it? Or take the risk of continuing the pregnancy to give birth to the child? The choice entangles the entire family. For doctors, when performing cardiac surgery, the following options are recommended depending on the condition and gestational week: (1) cardiac surgery to preserve the fetus and induce labor after surgery; (2) cardiac surgery to preserve the fetus and continue the pregnancy after surgery; (3) cardiac surgery with simultaneous cesarean section at the discretion of late-pregnant mothers; and (4) cardiac surgery after delivery. The effects of cardiac surgery on the fetus are mainly from extracorporeal circulation. Unlike the normal form of placental blood flow to the fetus, nonpulsatile perfusion of the extracorporeal circulation causes fetal hypoxia. During the rewarming phase of extracorporeal circulation, the peripheral vasodilatation of the pregnant woman and the reduction of placental blood flow perfusion, ischemia and hypoxia cause uterine agitation, which further aggravates fetal hypoxia. During extracorporeal circulation, the risk of hemorrhage increases, hemodilution leads to a decrease in maternal progesterone levels, and the risk of fetal abortion increases. Maternal systemic inflammatory response and microthrombosis also affect the placental microcirculation. My experience in maternal cardiac surgery is summarized as follows: (1) Maintain normothermia as much as possible for simple cardiac surgery, and adopt shallow hypothermia for complex surgery to reduce the stimulation of the uterus; (2) Maintain high blood pressure, high flow rate, and high perfusion pressure to ensure the effective circulation of the placenta, and to improve the effect of placental perfusion; (3) Maintain high erythrocyte hematocrit to improve the supply of oxygen to the fetus; (4) Inhibit the uterine contraction by adding progesterone in the pre-filling fluid; (5) Reduce the extracorporeal circulation diversion time and aortic block time to minimize the operation time; (6) Monitor the fetal heart rate and uterine contraction during the operation. Peace of mind for mother and child is the wish of all. May the world be free of disease, safe and happy.