Hi Nlyecoj, I am a cardiologist and I can safely say I have seen maximum number of Rheumatic Heart Disease(RHD) patients all over the world; India tops the list of numbers and aboriginal tribes living near Darwin Australia (been there) have maximum number per thousand population; the United States has not escaped with resurgence in Salt Lake City Utah in 1988. Every ten year there is a consensus meeting of American Heart Association to formulate guidelines of the treatment of Rheumatic Fever and its consequence Chronic Rheumatic Heart Disease. I am telling you tall this that being afraid is no solution. There are standard operative procedure for every complication of RHD. As you have not mentioned the diagnosis I presume (write back if I am wrong) you are likely to have disease of mitral valve and a combination of leakage of valve and some degree of narrowing. There are standard criteria of replacement of mitral valve which are based on echocardiography for example Left Ventricular Internal Diameter approaching 50 mm or volume approaching 30 ml per square meter body surface area and valve not amenable to repair. Therefore, your doctor knows what he/she is advising you and why. For, heart works as a pump with valves and muscle as driving force. You do not want to replace the valve so late that muscles are no longer efficient eminough to pump efficiently. Lastly, other doctor telling you artery was blocked; thrombo-embolism of blood clot is not uncommon in patients with rheumatic heart disease and it might have blocked a peripheral artery resulting in improper flow. There is no contraindication. I would urge you to go ahead with the right advice given by your cardiologist Dr Anil Grover Cardiologist