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The On-X Aortic Valve is a newer generation heart valve made of a unique material and design characteristics compared with earlier generations of mechanical heart valves. The On-X Aortic Valve is the only mechanical valve with FDA and CE approval to be used safely with less blood thinner (warfarin).1,* The AHA and ACC guidelines state that less blood thinner may be reasonable for patients with the mechanical On-X Aortic Valve.3 In a prospective randomized clinical trial, On-X Aortic Valve patients with a reduced blood thinner dose* had > 60% fewer bleeding events without an increase in risk of stroke.2 The On-X Aortic Valve, as a mechanical heart valve, has a much lower risk of reoperation than tissue (bioprosthetic) valves, with the additional benefit of less bleeding risk than other mechanical aortic valves because of the significantly lower amount of blood thinner required.2,*