AVR AND VWD

Dear doctor, i'm 34. I have severe AR AND soon need to pass AVR. but i have also VWD type 1b (35% vwf). my doctor thinks i should take mechanical valve because my factor level isn't too low AND i'm young. i'm not calm I'm really concern about the affects of blood thinners for the rest of my life.. what factors should i take into consideration when i finally choose the kind of valve (mech vs. bio)? avsha

As you mentioned, the things to be cnsidered are: The severity of the bleeding tendency (which seems to be low but this you should check again with your hematologist). Did you have bleeding episodes ? what was the severity ? Bio valve needs to be replaced after 10-15 years and you are young Mech. valve needs anticoagulation for life. If the bleeding tendency is low, than the mechanical valve seems to be a better choice. see a similar case report: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=2212781&query_hl=3&itool=pubmed_docsum