Mosaic^® and Mosaic Ultra^® Bioprostheses

AOA®* Treatment

The Mosaic^® bioprosthesis is treated with AOA^®, a widely researched treatment shown in animal studies to reduce the buildup of calcium. The Mosaic bioprosthesis is the only stented valve in the U.S. that incorporates this tissue treatment.

One way AOA treatment may interfere in the calcification process is by neutralizing the free aldehyde groups of glutaraldehyde. The free aldehyde groups bind to the amino groups of AOA molecules in the treatment solution -- a process called "capping," as shown in the following illustration. The capping of free aldehydes seems to result in a reduced tendency of the tissues to mineralize.

Another mechanism by which AOA treatment may inhibit calcification is by slowing down the diffusion of calcium ions through the treated tissues. Although long-term clinical data (10 or more years) are required to conclusively demonstrate the clinical relevance of animal research, the results of animal trials on AOA-treated tissue may afford insight into improved means of treatments to mitigate mineralization. ^1,2

1. Gott JP, Girardot MN, Girardot JMD. Refinement of the alpha aminooleic acid bioprosthetic valve anticalcification technique. Ann Thorac Surg 1997;64:50-8.

2. Walther T, Falk V, Autschbach R, et al. Comparison of different anticalcification treatments for stentless bioprostheses. Ann Thorac Surg 1998;66:S249-54

* AOA is a registered trademark of Biomedical Design, Inc., Atlanta, Georgia. No clinical data are available that evaluate the long-term impact of the AOA.