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Study: On-X Mechanical Heart Valve Replacement Shows Mortality Benefit

Written By: Adam Pick, Patient Advocate, Author & Website Founder
Page Last Updated: May 8, 2025

Since launching this website, I’ve noticed a trend favoring tissue valves over mechanical valves. While patients are attracted to the durability of a mechanical valve replacement, it seems as if many patients — of all age categories — want a Coumadin-free life. Plus, the possibility of valve-in-valve procedures appears to be another key factor in their selection process.

On-X Mecahnical Heart Valve With White Background

However, a study published in the Annals of Thoracic Surgery, reported that the On-X mechanical heart valve replacement performed favorably to tissue valves. More specifically, the On-X valve offered the 172 patients in the study a mortality benefit 7.5 years after surgery.

Dr. Vinay Badhwar - Heart Surgeon
Dr. Vinay Badhwar

Dr. Vinay Badhwar, who recently performed a successful surgery on Matthew Fountain, stated, “This study confirms that the use of the On-X valve with home INR monitoring can provide a combined better outcome (adverse events and mortality) than that achieved by tissue valves with this younger (under 65 years) patient group.”

As we have previously reported, the On-X mechanical heart valve replacement was under investigation in the PROACT Clinical Trial which examined whether or not the On-X valve replacement device required less or no Coumadin therapy after implant. To see the results of that clinical trial, please visit “Surgeon Q&A: Are Coumadin Requirements Being Lowered for the On-X Mechanical Valve Replacement?”.

Keep on tickin!
Adam

Written by Adam Pick
- Patient & Website Founder

Written by Adam Pick - Patient & Website Founder

Adam Pick is a heart valve patient and author of The Patient's Guide To Heart Valve Surgery. In 2006, Adam founded HeartValveSurgery.com to educate and empower patients. This award-winning website has helped over 10 million people fight heart valve disease. Adam has been featured by the American Heart Association and Medical News Today.

Randy Heimerl says on May 31st, 2012 at 2:42 pm

Hi.

I have been in the On-X study now for 3years. I was 52 when I had my aortic valve replaced with the On-X valve. I was put in the low risk group and have been taking Plavix vs. Coumadin. I just got checked out with an echo and was told everything looks great. I feel great. I don’t have to do any INR testing. Sure I bruise more easily, but I have not altered my life style, which is very active, to any degree.

Matt Fountain says on May 31st, 2012 at 9:57 pm

That’s me and that’s my surgeon. Hard to believe it will be 1 year (1 week from today)! Feel great with my ON-X valve.

Thanks for all the info Adam.

Matt Fountain

Javier Salgado says on June 1st, 2012 at 1:54 pm

I’ve had my ON-X Valve since June 2010, when will we find out if Coumadin is or is not needed? When will this study conclude? Anybody? Thank you.

Randy Heimerl says on June 1st, 2012 at 5:43 pm

I believe the study will go at least 2 more yrs. At one time they talked about extending it, but I have not heard anymore on that. The study has been very positive so far, producing good results. I know I will not have to go on Coumadin as I will continue on Plavix. I am not sure how the rest of you will be handled. Go to the On-X Proact Website, there may be a number to call with more info.

Javier Salgado says on June 3rd, 2012 at 5:27 pm

Thank you Randy.

Rick says on June 6th, 2012 at 11:34 am

I have an On-X aortic valve and am part of the PROACT study. I was 51 in July 2009 when my surgeon, Richard Cook, performed the surgery. My body doesn’t respond to plavix, so I’m in the group which takes warfarin. I have a home INR monitor and it’s been smooth sailing all along.

Proud to be part of an important and ground-breaking study.

David L. Mooney says on July 25th, 2012 at 11:14 pm

Mitral Valve replaced with ON_X August 10 2009, Surgeon wants INR 2-3, Self Check at home.Doing well.

Darrell Rowbury says on August 9th, 2013 at 9:49 am

I recently had an Aortic valve replacement utilizing the On x mechanical valve. I have been told that is has a leak back into the heart. I have also been told that this will not be a problem and will not need to be fixed. Do you have information concerning this sort of a situation.

Adam Pick says on August 9th, 2013 at 11:59 am

Hi Darrell,

Check out this video about murmurs (leaky valves) after heart surgery:

http://www.heart-valve-surgery.com/heart-surgery-blog/2012/10/01/heart-murmur-after-valve-surgery-dr-luis-castro/

I hope that helps!
Adam

drivetopless says on September 21st, 2017 at 11:34 am

Hi, All-
I got my On-X in 2010 and doing great. I take warfarin and a baby aspirin. I home test my INR and keep my INR 1.5 to 2.5. I eat all the greens I want– I’m just consistent in the daily amount. I actually am okay with warfarin because people have been taking it much longer than Plavix. But if we can go to a baby aspirin one day, that would be awesome. I relocated from Atlanta (where I had surgery) to greater Chicago. It has been disturbing that the cardiologists here are not as aware of On-X and the low-dose benefits. I had to tell them about it. If anyone knows a good cardiologist in the Naperville, IL area I’d appreciate it.