Mechanical Aortic Valve

[heartjunior]

I was born with congenital aortic stenosis and had an ATS AP size 20mm replacing my native valve at the age of 18. I have been on warfarin ever since and i am now 30 years old. I also have migraine with aura since a teenager. Recently i had a brain MRI/MRA as i've been getting more migraines and seen a neurologist. Fortunately neurologist said MRI looked normal "ASIDE FROM MINOR CHRONIC WHITE MATTER CHANGES (PRESUMABLY DUE TO HIS HEART VALVE)". And this sentence prompted me to read the radiologist MRI report where it said "there are 10 foci of old blood product, not clustered or peripherally of predominance, likely due to micro-embolic phenomena related to the prosthetic valve". I did a lot of research into cerebral microbleeds and white matter changes, am i going to get dementia at an old age? Or do you think these microbleeds is due to unlucky subtherapeutic INR at some stage which means i should do more regular INR testing(sometimes i do it every 3 months...)
If neurologist said its minor chronic white matter changes, is that worrisome since its chronic(even if its minor now?) or would this not get worse if my INR is therapeutic?
Lastly, i do have blurry vision on both sides and also VERY bad sensitivity to light and computer screen almost everyday ever since i got migraine. Can this actually be due to the microemboli from the MRI?

[ayl291]

Tough to say.  I'd seek another neurono opinion.  The good thing is that many people get paradoxical emboli duen
to pfo and are not affected permanently.