I have rheumatic heart disease and venous insufficiency. What are my options?

Coordinate care. In a situation like this, it is important for you to see a vein specialist (phlebologist ) about your veins. Your phlebologist should then discuss your case with your cardiologist. If both agree that you would benefit from having vein treatment, they can coordinate your care to make sure that treatment is safe for your heart and effective for your veins. Nowadays, major surgery is rarely needed.
Multiple. See your cardiologist about the heart issue and then a vascular surgeon about the venous insufficiency. There are many options with venous insufficiency. The available optons depend upon the underlying pathology.
Treat venous disease. There is really no contraindication for treating venous disease by laser ablation. The anesthesia is local and minimal and should not be a factor. .